Differential Diagnosis for Pulsating Bilateral Upper Abdominal Pain
- Single most likely diagnosis
- Peptic Ulcer Disease: This condition is a common cause of upper abdominal pain and can present with pulsating pain if the ulcer is close to a major blood vessel. The pain is often bilateral and can be exacerbated by food or anti-inflammatory drugs.
- Other Likely diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause upper abdominal pain that may be pulsating due to the reflux of stomach acid into the esophagus. The pain is often bilateral and can be worsened by lying down or eating certain foods.
- Cholecystitis: Inflammation of the gallbladder can cause upper abdominal pain that may be pulsating, especially if a stone is obstructing the cystic duct. The pain is often bilateral and can radiate to the right shoulder.
- Pancreatitis: Inflammation of the pancreas can cause upper abdominal pain that may be pulsating, especially if the pancreas is enlarged or if there is a pseudocyst. The pain is often bilateral and can radiate to the back.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic Dissection: A tear in the aorta can cause severe, pulsating upper abdominal pain that can be bilateral. This is a medical emergency that requires immediate attention.
- Ruptured Abdominal Aortic Aneurysm (AAA): A ruptured AAA can cause severe, pulsating upper abdominal pain that can be bilateral. This is a medical emergency that requires immediate attention.
- Mesenteric Ischemia: Reduced blood flow to the intestines can cause severe, pulsating upper abdominal pain that can be bilateral. This is a medical emergency that requires immediate attention.
- Rare diagnoses
- Splenic Artery Aneurysm: A rare condition where the splenic artery is dilated, which can cause pulsating upper abdominal pain. This is often asymptomatic but can rupture and cause severe bleeding.
- Median Arcuate Ligament Syndrome: A rare condition where the median arcuate ligament compresses the celiac artery, causing pulsating upper abdominal pain. This is often asymptomatic but can cause chronic abdominal pain.