Differential Diagnosis for Upper Left Quadrant Pain
The following differential diagnosis is organized into categories to help identify the possible causes of upper left quadrant pain, excluding pancreatic and kidney issues.
Single Most Likely Diagnosis
- Gastritis or Peptic Ulcer Disease: This is a common cause of upper left quadrant pain, often related to inflammation of the stomach lining or ulcers in the stomach or duodenum. Symptoms can include burning pain, nausea, and vomiting.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause upper left quadrant pain due to the reflux of stomach acid into the esophagus, leading to symptoms like heartburn and regurgitation.
- Splenic Infarction or Rupture: Although less common, issues with the spleen can cause upper left quadrant pain. Splenic infarction occurs when the blood supply to the spleen is blocked, while rupture is a more severe condition where the spleen tears, often due to trauma.
- Hiatal Hernia: A hiatal hernia, where part of the stomach pushes up through the diaphragm, can cause upper left quadrant pain, especially after eating or when lying down.
Do Not Miss Diagnoses
- Pulmonary Embolism: Although the primary symptom of a pulmonary embolism is typically shortness of breath, it can sometimes present with chest or upper quadrant pain, making it crucial not to miss this potentially life-threatening condition.
- Aortic Dissection: An aortic dissection, where the inner layer of the aorta tears, can cause severe, tearing pain that may be felt in the upper back or left quadrant, and is a medical emergency.
- Cardiac Ischemia or Myocardial Infarction: Heart conditions like ischemia or myocardial infarction can sometimes present with pain referred to the upper left quadrant, especially if the pain is related to the heart's blood supply.
Rare Diagnoses
- Splenic Artery Aneurysm: A rare condition where an aneurysm forms in the splenic artery, which can cause upper left quadrant pain if it ruptures.
- Left Diaphragmatic Hernia: A congenital or acquired condition where abdominal contents herniate through the diaphragm, potentially causing upper left quadrant pain.
- Tumors of the Stomach or Spleen: Although rare, tumors in the stomach or spleen can cause upper left quadrant pain, often accompanied by other symptoms like weight loss or fatigue.