Differential Diagnosis for Solar Plexus Pain

The solar plexus, also known as the celiac plexus, is a complex network of nerves located in the upper abdomen. Pain in this area can be caused by a variety of conditions. Here is a differential diagnosis organized into categories:

• Single Most Likely Diagnosis

  • Gastroesophageal Reflux Disease (GERD): This condition is characterized by the backflow of stomach acid into the esophagus, leading to pain and discomfort in the upper abdomen, including the solar plexus area. The proximity of the esophagus to the solar plexus and the common occurrence of GERD make it a likely cause.

• Other Likely Diagnoses

  • Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause pain that radiates to the solar plexus area. The pain is often described as burning or gnawing and can be exacerbated by eating.
  • Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that may be felt in the solar plexus area. The pain is often constant and may radiate to the back.
  • Cholecystitis: Inflammation of the gallbladder can cause pain in the right upper quadrant of the abdomen, which may also be felt in the solar plexus area.

• Do Not Miss Diagnoses

  • Myocardial Infarction: Although less common, myocardial infarction (heart attack) can present with pain in the upper abdomen, including the solar plexus area, especially if the inferior wall of the heart is involved. Missing this diagnosis can be fatal.
  • Pulmonary Embolism: In some cases, a pulmonary embolism can cause referred pain to the upper abdomen, including the solar plexus area, if the embolism involves the lung bases.
  • Aortic Dissection: A tear in the aorta can cause severe, tearing pain that may be felt in the chest and radiate to the abdomen, including the solar plexus area.

• Rare Diagnoses

  • Neurogenic Tumors: Tumors arising from the nerves in the solar plexus area, such as neuroblastomas or ganglioneuromas, can cause pain in this region.
  • Celiac Plexus Neuropathy: Damage to the nerves in the celiac plexus can cause chronic pain in the solar plexus area.
  • Splanchnic Nerve Entrapment: Entrapment of the splanchnic nerves, which are part of the solar plexus, can cause abdominal pain that may be localized to the solar plexus area.