Causes of epigastric abdominal pain: Difference between revisions

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| [[Abdominal pain resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
| [[Abdominal pain resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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{| class="infobox" style="float:right;"
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| [[File:Critical_Pathways.gif|88px|link=Abdominal pain critical pathways]]|| <br> || <br>
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{{Abdominal pain}}
{{Abdominal pain}}
{{CMG}}; '''Associate Editor-In-Chief: '''{{Hilda}}
{{CMG}}; {{AE}} {{Hilda}}


==Overview==
==Overview==
[[Epigastric pain]] is localized in upper central region of the [[abdomen]]. Sudden onset of [[epigastric pain]] is suggestive of [[pancreatitis]], especially when it radiates to the back and is associated with [[anorexia]], [[nausea]] and [[vomiting]]. Subacute or chronic [[epigastric pain]] is challenging to assess. In many situations, physicians are unable to accurately diagnose such pain solely based on history and physical examination.<ref name="Heikkinen-2000">{{Cite journal  | last1 = Heikkinen | first1 = M. | last2 = Pikkarainen | first2 = P. | last3 = Eskelinen | first3 = M. | last4 = Julkunen | first4 = R. | title = GPs' ability to diagnose dyspepsia based only on physical examination and patient history. | journal = Scand J Prim Health Care | volume = 18 | issue = 2 | pages = 99-104 | month = Jun | year = 2000 | doi =  | PMID = 10944064 }}</ref><ref name="Thomson-2003">{{Cite journal  | last1 = Thomson | first1 = AB. | last2 = Barkun | first2 = AN. | last3 = Armstrong | first3 = D. | last4 = Chiba | first4 = N. | last5 = White | first5 = RJ. | last6 = Daniels | first6 = S. | last7 = Escobedo | first7 = S. | last8 = Chakraborty | first8 = B. | last9 = Sinclair | first9 = P. | title = The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian Adult Dyspepsia Empiric Treatment - Prompt Endoscopy (CADET-PE) study. | journal = Aliment Pharmacol Ther | volume = 17 | issue = 12 | pages = 1481-91 | month = Jun | year = 2003 | doi =  | PMID = 12823150 }}</ref><ref name="Bytzer-1996">{{Cite journal  | last1 = Bytzer | first1 = P. | last2 = Hansen | first2 = JM. | last3 = Havelund | first3 = T. | last4 = Malchow-Møller | first4 = A. | last5 = Schaffalitzky de Muckadell | first5 = OB. | title = Predicting endoscopic diagnosis in the dyspeptic patient: the value of clinical judgement. | journal = Eur J Gastroenterol Hepatol | volume = 8 | issue = 4 | pages = 359-63 | month = Apr | year = 1996 | doi =  | PMID = 8781906 }}</ref> A common cause of [[epigastric pain]] is [[dyspepsia]] which may be associated with abdominal fullness, [[bloating]] or [[nausea]].
Epigastric pain is pain localized in the upper central region of the [[abdomen]]. Sudden onset of epigastric pain is suggestive of [[pancreatitis]], especially when it radiates to the back and is associated with [[anorexia]], [[nausea]] and [[vomiting]]. Subacute or chronic [[epigastric pain]] is challenging to assess. In many situations, physicians are unable to accurately diagnose such pain solely based on history and physical examination.<ref name="Heikkinen-2000">{{Cite journal  | last1 = Heikkinen | first1 = M. | last2 = Pikkarainen | first2 = P. | last3 = Eskelinen | first3 = M. | last4 = Julkunen | first4 = R. | title = GPs' ability to diagnose dyspepsia based only on physical examination and patient history. | journal = Scand J Prim Health Care | volume = 18 | issue = 2 | pages = 99-104 | month = Jun | year = 2000 | doi =  | PMID = 10944064 }}</ref><ref name="Thomson-2003">{{Cite journal  | last1 = Thomson | first1 = AB. | last2 = Barkun | first2 = AN. | last3 = Armstrong | first3 = D. | last4 = Chiba | first4 = N. | last5 = White | first5 = RJ. | last6 = Daniels | first6 = S. | last7 = Escobedo | first7 = S. | last8 = Chakraborty | first8 = B. | last9 = Sinclair | first9 = P. | title = The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian Adult Dyspepsia Empiric Treatment - Prompt Endoscopy (CADET-PE) study. | journal = Aliment Pharmacol Ther | volume = 17 | issue = 12 | pages = 1481-91 | month = Jun | year = 2003 | doi =  | PMID = 12823150 }}</ref><ref name="Bytzer-1996">{{Cite journal  | last1 = Bytzer | first1 = P. | last2 = Hansen | first2 = JM. | last3 = Havelund | first3 = T. | last4 = Malchow-Møller | first4 = A. | last5 = Schaffalitzky de Muckadell | first5 = OB. | title = Predicting endoscopic diagnosis in the dyspeptic patient: the value of clinical judgement. | journal = Eur J Gastroenterol Hepatol | volume = 8 | issue = 4 | pages = 359-63 | month = Apr | year = 1996 | doi =  | PMID = 8781906 }}</ref> A common cause of epigastric pain is [[dyspepsia]] which may be associated with abdominal fullness, [[bloating]] or [[nausea]].


==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
Life-threatening causes include conditions which result in death or permanent disability within 24 hours if left untreated.
*[[Acute pancreatitis]]
*[[Acute pancreatitis]]
*[[Aortic aneurysm|Aortic aneurysm]]
*[[Esophageal perforation]]
*[[Esophageal perforation]]
*[[Myocardial ischemia]]
*[[Myocardial ischemia]]
*[[Perforated duodenal ulcer]]
*[[Perforated duodenal ulcer]]
*[[Pulmonary embolism]]
*[[Pulmonary embolism]]
*[[aortic aneurysm|Ruptured aortic aneurysm]]
*[[Ruptured spleen]]
*[[Ruptured spleen]]
<font color="white">{{Smallcaps|{{PAGENAME}} developed by WikiDoc.org}}</font>


===Common Causes===
===Common Causes===
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*[[Pancreatitis]]
*[[Pancreatitis]]
*[[Peptic ulcer disease]]
*[[Peptic ulcer disease]]
<font color="white">{{Smallcaps|{{PAGENAME}} developed by WikiDoc.org}}</font>


===Causes by Organ System===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Myocardial ischemia]], [[aortic aneurysm|aortic aneurysm]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Myocardial ischemia]], [[aortic aneurysm|ruptured aortic aneurysm]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"|  
|bgcolor="Beige"| [[Acute pancreatitis]],  [[pancreatitis]]
[[Acute pancreatitis]],  [[pancreatitis]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"|
|bgcolor="Beige"|
[[infection|Chronic infection]], [[giardiasis]], [[intestinal parasite]], [[tuberculosis]]
[[infection|Chronic infection]], [[giardiasis]], [[intestinal parasite]], [[tuberculosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"|  
|bgcolor="Beige"| [[hepatocellular carcinoma|Hepatic tumors]], [[lymphomas]], [[pancreatic cancer|pancreatic tumors]], [[renal cell carcinoma]]
[[hepatocellular carcinoma|Hepatic tumors]], [[lymphomas]], [[pancreatic cancer|pancreatic tumors]], [[renal cell carcinoma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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{{col-break|width=33%}}
{{col-break|width=33%}}
*[[Acute pancreatitis]]
*[[Acute pancreatitis]]
*[[Aortic aneurysm|Aortic aneurysm]]
*[[Pneumonia|Basal pneumonia]]
*[[pneumonia|Basal pneumonia]]
*[[Bile duct tumor]]
*[[Bile duct tumor]]
*[[Cholecystitis]]
*[[Cholecystitis]]
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*[[Esophageal perforation]]
*[[Esophageal perforation]]
*[[Gallbladder cancer]]
*[[Gallbladder cancer]]
*[[Gastric cancer|Gastric tumors]]
{{col-break|width=33%}}
{{col-break|width=33%}}
*[[Gastric cancer|Gastric tumors]]
 
*[[Gastritis]]
*[[Gastritis]]
*[[Gastroesophageal reflux disease]] ([[GERD]])
*[[Gastroesophageal reflux disease|Gastroesophageal reflux disease (GERD)]]
*[[Giardiasis]]
*[[Giardiasis]]
*[[Hepatocellular carcinoma|Hepatic tumors]]
*[[Hepatocellular carcinoma|Hepatic tumors]]
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*[[Pancreatic cancer|Pancreatic tumors]]
*[[Pancreatic cancer|Pancreatic tumors]]
*[[Pancreatitis]]
*[[Pancreatitis]]
*[[Peptic ulcer disease]]
{{col-break|width=33%}}
{{col-break|width=33%}}
*[[Peptic ulcer disease]]
 
*[[Perforated duodenal ulcer]]
*[[Perforated duodenal ulcer]]
*[[Pleuritis]]
*[[Pleuritis]]
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*[[Referred pain]]
*[[Referred pain]]
*[[Renal cell carcinoma]]
*[[Renal cell carcinoma]]
*[[aortic aneurysm|Ruptured aortic aneurysm]]
*[[Ruptured spleen]]  
*[[Ruptured spleen]]  
*[[Splenic infarction]]
*[[Splenic infarction]]
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*[[Ulcerative colitis]]
*[[Ulcerative colitis]]
{{col-end}}
{{col-end}}
<font color="white">{{Smallcaps|{{PAGENAME}} developed by WikiDoc.org}}</font>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


{{Gastroenterology}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
[[Category:Crowdiagnosis]]
[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Gynecology]]
[[Category:Gynecology]]
[[Category:Gastroenterology]]
[[Category:Medicine]]
[[Category:Emergency medicine]]
[[Category:Signs and symptoms]]
[[Category:Primary care]]
[[Category:Surgery]]
[[Category:Surgery]]
[[Category:Needs causes]]
[[Category:Needs overview]]
{{WH}}
{{WS}}

Latest revision as of 20:50, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2]

Overview

Epigastric pain is pain localized in the upper central region of the abdomen. Sudden onset of epigastric pain is suggestive of pancreatitis, especially when it radiates to the back and is associated with anorexia, nausea and vomiting. Subacute or chronic epigastric pain is challenging to assess. In many situations, physicians are unable to accurately diagnose such pain solely based on history and physical examination.[1][2][3] A common cause of epigastric pain is dyspepsia which may be associated with abdominal fullness, bloating or nausea.

Causes

Life Threatening Causes

Life-threatening causes include conditions which result in death or permanent disability within 24 hours if left untreated.

Causes of epigastric abdominal pain developed by WikiDoc.org

Common Causes

Causes of epigastric abdominal pain developed by WikiDoc.org

Causes by Organ System

Cardiovascular Myocardial ischemia, ruptured aortic aneurysm
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine Acute pancreatitis, pancreatitis
Environmental No underlying causes
Gastroenterologic Bile duct tumor, cholecystitis, cholecystolithiasis, delayed gastric emptying, dyspepsia, esophageal perforation, gallbladder cancer, gastric tumors, gastritis, gastroesophageal reflux disease (GERD), colon cancer, hepatic tumors, hepatomegaly, irritable bowel syndrome, pancreatic tumors, pancreatitis, peptic ulcer disease, perforated duodenal ulcer, postcholecystectomy syndrome, ruptured spleen, splenic infarction, ulcerative colitis
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease

Chronic infection, giardiasis, intestinal parasite, tuberculosis

Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Hepatic tumors, lymphomas, pancreatic tumors, renal cell carcinoma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Basal pneumonia, pleuritis, pulmonary embolism
Renal/Electrolyte pyelonephritis, renal cell carcinoma
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma Ruptured spleen
Urologic No underlying causes
Miscellaneous Referred pain

Causes by Organ System developed by WikiDoc.org, Copyleft 2013

Causes in Alphabetical Order

Causes of epigastric abdominal pain developed by WikiDoc.org

References

  1. ↑ Heikkinen, M.; Pikkarainen, P.; Eskelinen, M.; Julkunen, R. (2000). "GPs' ability to diagnose dyspepsia based only on physical examination and patient history". Scand J Prim Health Care. 18 (2): 99–104. PMID 10944064. Unknown parameter |month= ignored (help)
  2. ↑ Thomson, AB.; Barkun, AN.; Armstrong, D.; Chiba, N.; White, RJ.; Daniels, S.; Escobedo, S.; Chakraborty, B.; Sinclair, P. (2003). "The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian Adult Dyspepsia Empiric Treatment - Prompt Endoscopy (CADET-PE) study". Aliment Pharmacol Ther. 17 (12): 1481–91. PMID 12823150. Unknown parameter |month= ignored (help)
  3. ↑ Bytzer, P.; Hansen, JM.; Havelund, T.; Malchow-Møller, A.; Schaffalitzky de Muckadell, OB. (1996). "Predicting endoscopic diagnosis in the dyspeptic patient: the value of clinical judgement". Eur J Gastroenterol Hepatol. 8 (4): 359–63. PMID 8781906. Unknown parameter |month= ignored (help)

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