Differential Diagnosis for Gastritis Radiating into Back

• Single most likely diagnosis
  • Peptic Ulcer Disease: This is the most likely diagnosis because gastritis and peptic ulcers often present with epigastric pain that can radiate to the back. The pain is typically exacerbated by food and can be relieved by antacids.
• Other Likely diagnoses
  • Gastroesophageal Reflux Disease (GERD): GERD can cause epigastric pain that radiates to the back, especially after eating or at night. It is often associated with symptoms like heartburn and regurgitation.
  • Pancreatitis: Acute or chronic pancreatitis can cause severe abdominal pain that radiates to the back. The pain is often constant and may be accompanied by nausea, vomiting, and fever.
  • Cholecystitis: Inflammation of the gallbladder can cause right upper quadrant abdominal pain that radiates to the back, especially after fatty meals.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Myocardial Infarction: Although less common, myocardial infarction (heart attack) can present with epigastric pain or discomfort that radiates to the back, especially in women or diabetic patients. It is crucial to consider this diagnosis due to its high mortality rate if missed.
  • Aortic Dissection: A tear in the aorta can cause severe, tearing chest pain that radiates to the back. This is a medical emergency that requires immediate attention.
  • Esophageal Rupture: A rupture of the esophagus can cause severe chest pain that radiates to the back, often accompanied by difficulty swallowing and shortness of breath.
• Rare diagnoses
  • Gastric Cancer: Although rare, gastric cancer can cause epigastric pain that radiates to the back, especially in older adults or those with a family history of the disease.
  • Splenic Artery Aneurysm: A rare condition where an aneurysm forms in the splenic artery, which can cause abdominal pain that radiates to the back, especially if it ruptures.
  • Duodenal Diverticulitis: Inflammation of a duodenal diverticulum can cause abdominal pain that radiates to the back, often accompanied by fever and nausea.