Definition
The left upper abdomen connects directly to the left costal arch and runs approximately to the navel. Any type of pain that occurs in this area can be described as left-sided upper abdominal pain. The type of pain can vary greatly, depending on the underlying cause, and is therefore an important indication of which disease could be the cause of the pain. The pain can radiate from organs located under the abdominal wall, such as the stomach, intestines or spleen, as well as from other regions of the body into the left abdomen. General information about upper abdominal pain can be found here: Upper abdominal pain
General information
In medicine, the abdomen is divided into four quadrants, with a vertical and a horizontal line running through the navel region. The upper abdomen is thus divided into the right and left upper abdomen. In addition, the stomach area (epigastrium), in the middle upper abdomen, is often considered separately. It should be noted that it is not always possible to determine the cause of the pain with certainty from the location of the pain, since in some diseases the pain radiates and each patient perceives pain differently. You can find an overview of pain on the left side of this page: Pain on the left side of the body
Causes
Left upper abdominal pain can have various causes. They are usually caused by organs adjacent to this area. Accordingly, the cause of these complaints often lies in the stomach, e.g. caused by an irritable stomach syndrome, an inflammation of the mucous membrane of the stomach (gastritis), an ulcer of the mucous membrane of the stomach (ulcer) or also a malignant degeneration of the mucous membrane of the stomach, a stomach carcinoma.
The duodenum is directly connected to the stomach. There, too, ulcers can develop as a result of a bacterial infection with the bacterium Helicobacter pylori or, secondarily, as a result of an inflammation of the stomach lining with increased production of gastric acid. These can also cause left upper abdominal pain.
In the case of an inflammation of small sacs of the intestinal wall, usually in the large intestine, this is called diverticulitis. This typically causes left abdominal pain. The esophagus, which also connects directly to the stomach, can also cause left upper abdominal pain in the event of inflammation or malignant changes.
Another organ that can be the origin of the complaints is the pancreas. Pancreatitis is an inflammation of the pancreas and typically causes girdle-like pain that can radiate from the upper abdomen to the back. Pancreatic carcinoma can also cause pain in the left upper abdomen.
The spleen is also located in the left half of the body, but more towards the back. If, for example, it becomes greatly enlarged as a result of infection, it can cause left pain due to pressure on surrounding tissue. If the left upper abdominal pain is very severe and may radiate into the left shoulder, a splenic infarction must also be considered.
In this case, the spleen tissue is undersupplied due to occlusion of blood vessels and subsequently dies off, which is manifested by severe pain. A splenic abscess is also a possible symptom. The spleen can also rupture and bleed into the body if it is subjected to force or if the capsule tension is too great.
Left upper abdominal pain may also occur. If, in addition to these symptoms, the abdomen is also very tense and painful under pressure, this could also be peritonitis. Last but not least, a heart attack must always be taken into consideration when suffering from upper abdominal pain.
Especially a heart attack in women often manifests itself through untypical symptoms, so often through pain radiating into the upper abdomen. The same applies to an inflammation of the pericardium (pericarditis). Since the heart is located in the left thorax, the pain can also spread to the left half of the body.
In principle, pain in the upper abdomen can also originate in the aorta if an aneurysm, i.e. a bulge in the vessel wall, develops in it. Pain that begins in the back and then radiates into the upper abdomen is typical. If it is a so-called dissecting aortic aneurysm, the pain can also migrate, as the vessel wall continues to split.
Depending on the extent of the splitting, the pain also migrates.Shingles (herpes zoster), a viral disease caused by the chickenpox virus, also frequently causes complaints of the upper abdomen, with the additional characteristic rash of red, itchy blisters. This rash extends along the course of a nerve and is usually located on one side of the body only. This clinical picture can be accompanied by severe pain and burning sensation.
Typically, the nerve pain occurs 2-3 days before the rash. Many diseases can present themselves in different ways to patients. In some cases, diseases that are actually associated with the thorax region can also cause pain in the upper abdomen.
Examples are pleurisy, pneumonia, the already mentioned heart attack and pneumothorax. In pneumothorax, air enters the space between the lung and the pleura, causing the lung to collapse. The air often comes from burst emphysema vesicles on the lung surface, but it can also enter the space between the lungs through direct violent impact on the thorax with damage to the pleura (trauma, stabbing, etc.).
In principle, urological and gynecological diseases, which manifest themselves primarily in the lower abdomen, can also radiate into the upper abdomen and should be considered for differential diagnosis. Dilatation or bulging of the abdominal artery Noticeable pulsation in the abdomen, in case of tearing of acute abdominal pain caused by blood in the abdomen Diagnosis by ultrasound examination of the abdomen Therapy: if the diameter is small, it is possible to wait and check closely; if the bulging is very large, surgery should be performed immediately
- Expansion or sacculation of the abdominal artery
- Noticeable pulsation in the abdomen, in case of tearing acute abdominal pain caused by blood in the abdomen
- Diagnosis by ultrasound examination of the abdomen
- Therapy: if the diameter is small, you can wait and see how the bagging is progressing; if the bagging is very large, surgery should be performed immediately
- Complications: Laceration of the artery with severe blood loss
Tearing of the spleen capsule, e.g. due to an accident or a blow in the left abdomen Strongest, suddenly occurring pain, which is particularly strong when breathing (sometimes the pain does not appear until a few days after the injury) Diagnosis by ultrasound examination and CT of the abdomen Therapy: immediate operation (usually the spleen must be removed)
- Tearing of the spleen capsule e.g. due to an accident or a blow in the left abdomen
- Strongest, suddenly occurring pain, which is particularly strong when breathing (sometimes the pain does not appear until a few days after the injury)
- Diagnosis by ultrasound examination and CT of the abdomen
- Therapy: immediate surgery (usually the spleen has to be removed)
- Complications: severe blood loss, complications due to the operation
