Left upper quadrant abdominal pain

Background

• This page outlines the general approach to adult LUQ pain

Classification by Abdominal pain location

Side-by-side comparison of quadrants and regions.

Chart of commonly reported referred pain sites.

RUQ pain	Epigastric pain	LUQ pain
Flank pain	Diffuse abdominal pain	Flank pain
RLQ pain	Pelvic pain	LLQ pain

Differential Diagnosis

Left upper quadrant abdominal pain

• GERD
• Peptic ulcer disease with or without perforation
• Pancreatitis
• Splenic infarction/Splenic artery aneurysm rupture
• Pyelonephritis
• Bowel obstruction
• Myocardial Ischemia
• Pneumonia
• Pulmonary embolism
• Herpes zoster
• Pericarditis/Myocarditis
• Aortic Dissection

Workup

• CBC
• Chem
• LFTs
• Lipase
• Coags
• Urinalysis
• Urine pregnancy (females)
• ?ECG (if >50 or at risk for cardiac disease)
• ?RUQ US
• ?CXR
  • Consider if at risk for perforated ulcer

Management

• Treat underlying disease process
• Consider GI cocktail (Maalox Plus/Lidocaine Viscous 2%/Donnatol)

Disposition

• Disposition per underlying disease process

See Also

• Abdominal Pain
• Abdominal Pain (Peds)