Differential Diagnosis for Left Upper Quadrant Pain
The following is a list of potential diagnoses for left upper quadrant pain, categorized by likelihood and potential impact.
Single Most Likely Diagnosis
- Gastritis or peptic ulcer disease: This is a common cause of left upper quadrant pain, often related to Helicobacter pylori infection, non-steroidal anti-inflammatory drug (NSAID) use, or stress. The pain is typically epigastric, but can radiate to the left upper quadrant.
Other Likely Diagnoses
- Gastroesophageal reflux disease (GERD): GERD can cause pain in the left upper quadrant due to acid reflux and esophageal irritation.
- Pancreatitis: While pancreatitis typically causes mid-abdominal pain, it can radiate to the left upper quadrant, especially if the tail of the pancreas is involved.
- Splenic infarction or rupture: Splenic issues can cause severe left upper quadrant pain, often accompanied by radiation to the left shoulder.
- Diverticulitis: Inflammation of a diverticulum in the colon can cause left upper quadrant pain if the diverticulum is located in the splenic flexure.
Do Not Miss Diagnoses
- Myocardial infarction: Cardiac ischemia can cause referred pain to the left upper quadrant, especially if the inferior wall of the heart is involved.
- Pneumonia or pulmonary embolism: Respiratory issues can cause referred pain to the left upper quadrant, especially if the left lower lobe of the lung is involved.
- Aortic dissection: A tear in the aorta can cause severe, tearing pain that radiates to the left upper quadrant.
- Sickle cell crisis: Patients with sickle cell disease can experience severe pain due to vaso-occlusive crises, which can affect the spleen and cause left upper quadrant pain.
Rare Diagnoses
- Splenic artery aneurysm: A rare cause of left upper quadrant pain, often accompanied by a palpable mass.
- Left upper quadrant hernia: A rare type of hernia that can cause pain and discomfort in the left upper quadrant.
- Intestinal obstruction: A rare cause of left upper quadrant pain, often accompanied by nausea, vomiting, and abdominal distension.
- Retroperitoneal fibrosis: A rare condition that can cause left upper quadrant pain due to inflammation and fibrosis of the retroperitoneal tissues.