Pain in the left costal arch
Due to its location, diseases of the spleen can manifest themselves through pain in the area of the left ribs and the left costal arch. In its niche, the spleen is usually not palpable. It is only palpable if it is enlarged (e.g. in case of inflammation).
In this case, the enlarged organ may press on the nerves and cause pain in the ribs and costal arch. A disease that is often accompanied by severe swelling of the spleen is Pfeiffer’s glandular fever caused by the Epstein-Barr virus (EBV). In this case, sporting activities must be temporarily avoided, as the risk of rupture of the spleen is increased.
Spleen rupture is a rupture of the spleen due to the increased capsule tension. This causes heavy bleeding, which can quickly become life-threatening. A splenic infarction, i.e. the acute occlusion of an artery supplying the spleen, can also cause severe pain.
This can lead to the loss of spleen tissue. In a splenic infarction, the patient usually experiences severe pain, often including nausea, vomiting and fever. The differential diagnosis is a splenic abscess.
This involves an accumulation of pus in the spleen, which can also cause pain in the area of the left costal arch due to splenic swelling and compression of surrounding nerves. Acute pain in the area of the left costal arch or the left ribs can always be an indication of a cardiac cause. In the case of a heart attack, chest pain often occurs, which can radiate to the upper abdomen and ribs.
This symptomatology is particularly common in women. Radiation to the jaw, left arm and back is also observed. The stomach is located in the upper abdomen slightly to the left of the middle.
Inflammation of the stomach lining (gastritis), stomach ulcers or other stomach problems can therefore cause both upper abdominal pain and pain in the ribs. As with right-sided rib-arching, the intestine can also be the cause of the complaints on the left side. Inflammation is particularly common in the left side of the colon, e.g. diverticulitis, where small protrusions of the intestinal wall become inflamed.
Typically, this leads to left-sided pain in the lower abdomen; however, since the diverticula can occur anywhere in the bowel, a different localization of the symptoms is also conceivable. The pancreas is also located in the upper abdomen, slightly shifted to the left. Accordingly, diseases of this organ can also cause left-sided pain in the upper abdomen and rib area.
Inflammation of the pancreas (pancreatitis) is usually manifested by sudden, severe pain in the upper abdomen, which radiates in a belt-shaped manner into the back. The pain also radiates into the rib area. The patient’s abdomen is usually tense.
There is often additional nausea and vomiting, as well as fever and low blood pressure. Herpes zoster (shingles) can also occur on the left side of the body, just like on the right side. The burning and itchy, blister-shaped skin rash often causes severe pain in the rib area (see above).
Left-sided rib-arch pain can also occur as a result of incorrect movements or accidents. Strained muscles, torn muscle fibers and nerve irritation can be very painful, but are harmless overall and heal independently. In principle, the so-called lateral stitches can also cause pain in the costal arch region, since the diaphragm cramps up due to irregular or strong breathing and causes the stabbing pain. Another cause of side stitches, which is discussed, is a swelling of the spleen due to physical exertion. The increased capsule tension of the organ could also be responsible for the stabbing pain in the left costal arch region.
