Differential Diagnosis for Abdominal Pain Radiating to Left Shoulder Blade
- Single most likely diagnosis
- Pancreatitis: The pain of pancreatitis often radiates to the back, and the left shoulder blade is a common location due to the proximity of the pancreas to the left side of the spine and the referred pain pattern through the splanchnic nerves.
- Other Likely diagnoses
- Gastritis or Peptic Ulcer Disease: Inflammation of the stomach lining or ulcers in the stomach or duodenum can cause abdominal pain that radiates to the back, including the left shoulder blade area, especially if the pathology is located near the lesser curvature of the stomach.
- Splenic Infarction or Rupture: Given the spleen's location on the left side, conditions affecting it can cause pain that radiates to the left shoulder blade due to irritation of the diaphragm and referred pain.
- Left Kidney Stone or Pyelonephritis: While kidney stones or infections typically cause flank pain, severe cases can radiate pain to the abdomen and back, potentially reaching the left shoulder blade area.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ruptured Abdominal Aortic Aneurysm (AAA): Although less common, a ruptured AAA can present with abdominal pain radiating to the back, including the shoulder area, and is a medical emergency.
- Ectopic Pregnancy: In women of childbearing age, ectopic pregnancy can cause severe abdominal pain that may radiate to the back and shoulder area, and is a life-threatening condition if not promptly diagnosed and treated.
- Pulmonary Embolism: While typically presenting with respiratory symptoms, a pulmonary embolism can occasionally cause referred pain to the shoulder or back, especially if the embolism involves the upper lobes.
- Rare diagnoses
- Diaphragmatic Hernia: A hernia through the diaphragm can cause abdominal organs to irritate the diaphragm and cause referred pain to the shoulder area.
- Retroperitoneal Hemorrhage: Bleeding into the retroperitoneal space can cause abdominal and back pain, potentially radiating to the shoulder area, depending on the location and extent of the hemorrhage.
- Shingles (Herpes Zoster): In rare cases, shingles affecting the nerves that supply the abdomen and back can cause pain that radiates to the shoulder blade area before the characteristic rash appears.