Differential Diagnosis for Left Lower Back Pain Radiating to the Stomach
- Single most likely diagnosis: + Diverticulitis: This condition is characterized by inflammation of the diverticula in the colon, which can cause left lower quadrant abdominal pain, nausea, vomiting, and changes in bowel habits. The pain often starts in the lower back and radiates to the stomach. Given the acute onset and the nature of the pain, diverticulitis is a plausible diagnosis.
- Other Likely diagnoses: + Gastroenteritis: Inflammation of the stomach and intestines, usually due to infection, can cause abdominal pain, nausea, vomiting, and diarrhea. The pain can start in the back and move to the abdomen. + Constipation: Severe constipation can cause significant abdominal pain, nausea, and vomiting. The pain can radiate from the back to the abdomen. + Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic or acute abdominal pain, changes in bowel habits, and sometimes back pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.): + Appendicitis (even though it typically presents on the right side, it can occasionally present atypically): Appendicitis is an emergency that requires prompt surgical intervention. It can cause severe abdominal pain, nausea, vomiting, and fever. + Ectopic pregnancy: In women of childbearing age, an ectopic pregnancy can cause severe abdominal pain, vomiting, and can be life-threatening if not promptly diagnosed and treated. + Aortic dissection or abdominal aortic aneurysm: These are life-threatening conditions that can cause severe back or abdominal pain and require immediate medical attention. + Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain radiating to the back, nausea, vomiting, and can be life-threatening.
- Rare diagnoses: + Intestinal obstruction: A blockage in the intestine can cause severe abdominal pain, vomiting, and constipation. + Mesenteric ischemia: A reduction in blood flow to the intestines can cause severe abdominal pain, nausea, vomiting, and can be life-threatening. + Ovarian torsion or cyst rupture: In women, these conditions can cause severe abdominal pain and are emergencies requiring prompt surgical intervention.
Each of these diagnoses has a different set of risk factors, symptoms, and diagnostic approaches. A thorough medical history, physical examination, and diagnostic tests (such as imaging studies and laboratory tests) are necessary to determine the underlying cause of the symptoms.