Causes of epigastric abdominal pain

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Hilda Mahmoudi M.D., M.P.H.^[2]

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.^[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

Common Causes

Causes by Organ System

Cardiovascular	Myocardial ischemia, 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

References

↑ 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)
↑ 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)
↑ 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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[Heikkinen-2000-1] 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)

[Thomson-2003-2] 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)

[Bytzer-1996-3] 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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