Causes of left upper quadrant abdominal pain: Difference between revisions

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==Overview==
==Overview==
Left upper quadrant pain may originate from the chest, diaphragm, abdomen, peritoneum or general medical conditions.  Abdominal causes are generally due to the pathology involving spleen, stomach (may have epigastric pain, left upper quadrant pain or back pain), pancreas (may have epigastric or back pain), splenic flexure of the left colon (may have low abdominal pain or left flank pain), and left kidney (may have loin pain).  Pain orginating from intra-abdominal organ pathology may not localize accurately and diaphragmatic pain can be referred to the shoulder tip.
Left upper quadrant pain can originate from the chest, diaphragm, abdomen, peritoneum or general medical conditions.  Abdominal causes are generally due to the pathology involving spleen, stomach (also presents as epigastric and back pain), pancreas (usually present with epigastric and back pain), splenic flexure of the left colon (may have low abdominal pain or left flank pain) and left kidney (flank pain).  Pain originating from intra-abdominal organ pathology may not localize accurately and diaphragmatic pain can be referred to the shoulder tip.


==Causes of Left Upper Quadrant Abdominal Pain==
==Causes of Left Upper Quadrant Abdominal Pain==

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]

Overview

Left upper quadrant pain can originate from the chest, diaphragm, abdomen, peritoneum or general medical conditions. Abdominal causes are generally due to the pathology involving spleen, stomach (also presents as epigastric and back pain), pancreas (usually present with epigastric and back pain), splenic flexure of the left colon (may have low abdominal pain or left flank pain) and left kidney (flank pain). Pain originating from intra-abdominal organ pathology may not localize accurately and diaphragmatic pain can be referred to the shoulder tip.

Causes of Left Upper Quadrant Abdominal Pain

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular Abdominal aortic aneurysm rupture, infective endocarditis, intestinal lymphangiectasia, ischemic colitis, malignant hypertension, mesenteric artery ischemia, pulmonary arteriovenous malformations, pulmonary embolism, pulmonary infarction, purulent pericarditis, rheumatoid vasculitis, splenic artery aneurysm, splenic artery embolization, splenic infarction, systemic vasculitis
Chemical/Poisoning Algal toxin in shellfish, aluminum toxicity, arsenic poisoning, cadmium toxicity, chromium poisoning, copper poisoning, ecstasy overdose, ethylene glycol poisoning, food poisoning, gold, iron poisoning, lead poisoning, mercury poisoning, methanol, organophosphate poisoning, saw palmetto, silver poisoning, toxic mushrooms
Dental No underlying causes
Dermatologic Scarlet fever, scleroderma, shingles
Drug Side Effect Aspirin, colchicine toxicity, diclofenac, didanosine, fentanyl toxicity, hydroxyurea, ibuprofen, indomethacin, malignant hyperthermia, nonsteroidal anti-inflammatory drugs (NSAIDs), propylthiouracil, Reye's syndrome, statins, steroid abuse, thrombolytic therapy, tramadol toxicity, vitamin D toxicity
Ear Nose Throat No underlying causes
Endocrine Addisonian crisis, adrenal hemorrhage, adrenal tuberculosis, carcinoid, diabetic ketoacidosis, multiple endocrine neoplasia type 1, Zollinger-Ellison syndrome
Environmental Organophosphate poisoning, saw palmetto
Gastroenterologic Abdominal compartment syndrome, acute diverticulitis, acute pancreatitis, atraumatic splenic rupture, autoimmune pancreatitis, Bannayan-Zonana syndrome, bile reflux disease, bulimia nervosa, celiac disease, chronic constipation, collagenous colitis, colon cancer, colonic lymphoma, congestive splenomegaly, Crohn's disease, cystic metastasis to the spleen, eosinophilic gastroenteritis, familial adenomatous polyposis, Felty's syndrome, gastric carcinoma, gastrinoma, gastritis, gastroenteritis, Gaucher disease, hepatorenal syndrome, hiatus hernia, intestinal pseudo-obstruction, intussusception, irritable bowel syndrome, ischemic colitis, malignant peritoneal mesothelioma, milk-alkali syndrome, Ménétrier's disease, pancreatic cystic neoplasms, pancreatic tail cancer, peptic ulcer disease, perforated gastric ulcer, peritonitis, pernicious anemia, polycystic kidney disease with splenic cysts, porphyria, pseudocysts cystic splenosis, scarlet fever, scleroderma, somatostatinoma, splenic abscess, splenic infarction, splenic laceration and trauma, splenic lymphoma, splenosis, stress ulcer, subphrenic abscess, traumatic splenic rupture, typhoid fever, ulcerative colitis, visceral hamartoma, visceral hemangioma, volvulus, wandering spleen syndrome, Zollinger-Ellison syndrome
Genetic Beta thalassemia major, colon atresia, cystic fibrosis, Dent's disease, familial adenomatous polyposis, Gaucher disease, hereditary angio-oedema, Meckel syndrome, polycystic kidney disease with splenic cysts, porphyria, primary hyperoxaluria, sickle cell anemia, Von Hippel-Lindau disease, WAGR syndrome, Williams syndrome
Hematologic Acquired hemolytic anemia, antiphospholipid syndrome, beta thalassemia major, chronic lymphocytic leukemia, chronic myeloid leukemia, cryoglobulinemia, essential thrombocytosis, hairy cell leukemia, hereditary spherocytosis, lymphoma, MALT lymphoma, mastocytosis, myelofibrosis, plasma cell leukemia, polycythemia vera, porphyria, sickle cell anemia, Sézary syndrome, Waldenstrom macroglobulinemia
Iatrogenic Chromoendoscopy, cryoablation, exercise-induced gastrointestinal bleeding, gas following laparoscopy, gastric surgery, intra abdominal adhesions, large volume thoracentesis, magnetic resonance cholangiopancreatography, milk-alkali syndrome, nasogastric tubes, pancreaticoduodenectomy (Whipple procedure), percutaneous abdominal biopsy, peritoneal dialysis, post-ERCP perforation, post-traumatic cysts, radiation therapy, referred pain, splenic artery embolization
Infectious Disease Amebic dysentery, babesiosis, bacillary dysentery, botryomycosis, gastroenteritis, helicobacter pylori infection, histoplasmosis, infectious mononucleosis, infective endocarditis, inflammatory pleural effusions, intestinal worm infestation, kala-azar (visceral leishmaniasis), malaria, mediterranean spotted fever, miliary tuberculosis, mumps, mycobacterium avium complex, perinephric abscess, peritonitis, pneumonia, post streptococcal glomerulonephritis, purulent pericarditis, pyelonephritis, renal abscess, renal mucormycosis, renal tuberculosis, shingles, splenic abscess, splenic hydatid cyst, subphrenic abscess, tropical splenomegaly syndrome, typhoid fever, viral hemorrhagic fever, Weil syndrome, yellow fever
Musculoskeletal/Orthopedic Rib fracture, polymyositis
Neurologic Meckel syndrome
Nutritional/Metabolic Carbohydrate-deficient glycoprotein syndrome, cystinuria, Gaucher Disease, homocystinuria, hyperuricaemia, oxalosis
Obstetric/Gynecologic Eclampsia, endometriosis, gestational trophoblastic disease
Oncologic Bannayan-Zonana syndrome, chronic lymphocytic leukemia, chronic myeloid leukemia, colon cancer, colonic lymphoma, cystic metastasis to the spleen, Denys-Drash syndrome, essential thrombocytosis, familial adenomatous polyposis, gastric carcinoma, gastrinoma, hairy cell leukemia, malignant peritoneal mesothelioma, MALT lymphoma, mastocytosis, myelofibrosis, Ménétrier's disease, pancreatic tail cancer, plasma cell leukemia, polycythemia vera, renal angiosarcoma, renal cell carcinoma, somatostatinoma, splenic lymphoma, Sézary syndrome, tuberous sclerosis, tumor lysis syndrome, visceral hamartoma, visceral hemangioma, Von Hippel-Lindau disease, WAGR syndrome, Waldenstrom macroglobulinemia, Wilms tumor
Ophthalmologic No underlying causes
Overdose/Toxicity Cocaine overdose, contrast agents, fentanyl toxicity, steroid abuse, tramadol toxicity
Psychiatric Bulimia nervosa, intestinal pseudo-obstruction, irritable bowel syndrome, stress ulcer
Pulmonary Empyema, inflammatory pleural effusions, pneumonia, pulmonary arteriovenous malformations, pulmonary embolism, pulmonary infarction, systemic lupus erythematosus, Wegener's granulomatosis
Renal/Electrolyte Dent's disease, Denys-Drash syndrome, glomerulonephritis, Meckel syndrome, medullary cystic kidney disease, nephrocalcinosis, perinephric abscess, polycystic kidney disease with splenic cysts, pyelonephritis, renal angiosarcoma, renal cell carcinoma, renal mucormycosis, renal tuberculosis, renal tubular acidosis, scleroderma, systemic lupus erythematosus, tuberous sclerosis, tubulointerstitial nephritis, urinary outflow obstruction, Von Hippel-Lindau disease, WAGR syndrome, Wegener's granulomatosis, Weil syndrome, Williams syndrome, Wilms tumor, xanthogranulomatous pyelonephritis
Rheumatology/Immunology/Allergy Allergic gastroenteropathy, autoimmune gastritis, autoimmune pancreatitis, crohn's disease, cryoglobulinemia, Felty's syndrome, food intolerance, hereditary angio-oedema, pernicious anemia, Reye's syndrome, rheumatoid vasculitis, scarlet fever, systemic lupus erythematosus, systemic vasculitis, ulcerative colitis, Wegener's granulomatosis
Sexual Denys-Drash syndrome
Trauma Electrical burns, rib fractures, splenic laceration and hematoma, traumatic splenic rupture
Urologic No underlying causes
Miscellaneous Alcohol ingestion, chronic constipation, excessive caffeine, idiopathic, spicy food, splenosis

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