Differential Diagnosis for Left Upper Quadrant Pain
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is often the most common cause of left upper quadrant pain due to the proximity of the stomach to this area. Symptoms such as heartburn and regurgitation are common, and the pain can radiate to the left upper quadrant.
Other Likely Diagnoses
- Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause pain in the left upper quadrant, especially if the ulcer is located on the greater curvature of the stomach.
- Gastritis: Inflammation of the stomach lining can cause left upper quadrant pain, nausea, and vomiting.
- Pancreatitis: While pancreatitis typically causes mid-abdominal pain, it can sometimes radiate to the left upper quadrant, especially if the tail of the pancreas is involved.
- Splenic Infarction or Rupture: Conditions affecting the spleen, such as infarction or rupture, can cause severe left upper quadrant pain.
Do Not Miss Diagnoses
- Myocardial Infarction: Although typically presenting with chest pain, myocardial infarctions can sometimes cause referred pain to the left upper quadrant, especially if the inferior wall of the heart is involved.
- Pulmonary Embolism: A pulmonary embolism can cause sudden onset of chest pain that may radiate to the left upper quadrant if the embolism affects the lower lobes of the lung.
- Aortic Dissection: This is a life-threatening condition where the inner layer of the aorta tears, causing severe pain that can radiate to the back and left upper quadrant.
- Diabetic Ketoacidosis: Although more systemic in presentation, diabetic ketoacidosis can cause abdominal pain, including in the left upper quadrant, due to metabolic disturbances.
Rare Diagnoses
- Splenic Artery Aneurysm: A rare condition where an aneurysm forms in the splenic artery, which can cause left upper quadrant pain if it ruptures.
- Left Upper Lobe Pneumonia: Infection in the left upper lobe of the lung can cause pain that is referred to the left upper quadrant.
- Hiatal Hernia: A type of hernia where part of the stomach pushes up into the chest through an opening in the diaphragm, which can cause left upper quadrant pain, especially after eating.
- Intercostal Neuritis: Inflammation of the nerves between the ribs can cause sharp, stabbing pain in the left upper quadrant.