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left upper quadrant pain
Etiology:
1) gastritis*
2) peptic ulcer*
3) pancreatitis*
4) ruptured abdominal aortic aneurysm [1]
5) splenic infarct
6) mesenteric ischemia
7) referred pain from
- pneumonia
- myocardial infarction
- pulmonary embolism
8) other (see abdominal pain)
* gastritis & peptic ulcer do not present as acute pain [1]
* nephrolithiasis presents as flank pain or lower quadrant pain [1]
Clinical manifestations:
- nausea, vomiting
- diaphoresis
Laboratory:
- complete blood count
- comprehensive metabolic panel
- serum lipase & serum amylase
- cardiac enzymes: serum troponin-I
Special laboratory:
- electrocardiogram
- cardiac stress testing (acute)
- upper GI endoscopy (chronic)
Radiology:
- abdominal ultrasound
- abdominal CT
Notes:
- visceral pain localizes poorly in the abdomen
- consider all possible sources of abdominal pain
Related
left upper quadrant
General
abdominal pain
References
- Casey J, Vaidya A, Frank N et al
Dissecting a Case of Abdominal Pain
N Engl J Med 2016; 375:e35. October 27, 2016
http://www.nejm.org/doi/full/10.1056/NEJMimc1516704