Differential Diagnosis for Left Sided Abdominal Pain Radiating to Lower Back

Single Most Likely Diagnosis

• Nephrolithiasis (Kidney Stones): This condition often presents with severe, crampy pain that starts in the flank and radiates to the lower abdomen or groin. The pain can be on one side and may radiate to the back, making it a likely cause for the described symptoms.

Other Likely Diagnoses

• Pyelonephritis: An infection of the kidney, which can cause flank pain that radiates to the lower back, along with symptoms like fever and dysuria.
• Diverticulitis: Inflammation of a diverticulum in the colon, which can cause left lower quadrant abdominal pain that may radiate to the back.
• Ovarian Cyst or Torsion: These conditions can cause lower abdominal pain that radiates to the back, especially if the cyst is large or has ruptured, or if the ovary has torsioned.

Do Not Miss Diagnoses

• Abdominal Aortic Aneurysm (AAA): Although less common, an AAA can cause severe back pain that radiates to the abdomen, and it is a medical emergency.
• Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain that radiates to the back, often accompanied by nausea and vomiting.
• Ectopic Pregnancy: A pregnancy that develops outside the uterus, which can cause severe abdominal pain that may radiate to the back, and is a medical emergency.

Rare Diagnoses

• Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodes of severe hypertension, headache, sweating, and abdominal or back pain.
• Retroperitoneal Hematoma or Abscess: Collections of blood or pus in the retroperitoneal space can cause back and abdominal pain, often due to trauma or infection.
• Splenomegaly or Splenic Infarction: Enlargement or infarction of the spleen can cause left upper quadrant abdominal pain that may radiate to the back, often associated with systemic symptoms like fever.