Upper Left Abdominal Pain

Upper Left Abdominal Pain connects directly to the left costal arch and runs approximately to the belly button . Any type of pain that occurs in this area can be described as Upper Left Abdominal Pain. The type of pain can, depending on the underlying cause, vary greatly and is therefore an important indication that disease for complaints could be the cause. The pain may originate from organs lying under the abdominal wall, such as the stomach, intestine or spleen, as well as radiate from other regions of the body into the left abdomen.

Upper Left Abdominal Pain


In medicine, the abdomen is divided into four quadrants , with a vertical and a horizontal line drawn through the umbilical region. The upper abdomen is thus divided into the right and left upper abdomen. Moreover, often the stomach area ( epigastric ), considered separately in the central upper abdomen. It should be noted that the cause of pain can not always be reliably deduced from the localization of the pain, since in some diseases the pain radiates and, in addition, each patient perceives pain differently.


Upper Left Abdominal Pain can have various causes . They are usually caused by organs adjacent to this area . Correspondingly frequently the cause of these complaints lies in the stomach , for example caused by an irritable- gastric syndrome , a gastritis ( gastritis ), an ulcer of the gastric mucosa ( ulcer ) or even a malignant degeneration of the gastric mucosa, a gastric carcinoma .

Directly to the stomach closes duodenum ( duodenum to). There, too, ulcers can be caused by a bacterial infection with the bacterium Helicobacter pylori or secondarily by a gastritis with increased gastric acid production . These can also cause lUpper Left Abdominal Pain. Inflammation of small outpourings of the intestinal wall, usually in the large intestine , is called diverticulitis . This typically causes left abdominal pain. Also, the esophagus , which also connects directly to the stomach, in inflammation or malignant change causing Upper Left Abdominal Pain.

Another organ that may be the origin of the complaints, the pancreas ( pancreatic ). In pancreatitis ( pancreatitis ) there is typically belt-like pain that can radiate from the area of the upper abdomen to the back. A pancreatic carcinoma can also cause Upper Left Abdominal Pain.

The spleen is also in the left half of the body, but more towards the back. For example, if it enlarges greatly due to infection , it can cause left pain by pressure on surrounding tissue.

For very severe upper abdominal pain, which may also radiate to the left shoulder, must also be thought of a splenic infarction . Closure of blood vessels leads to insufficient supply of spleen tissue and, as a consequence, to its death, which is manifested by severe pain. A spleen abscess is also a possibility for the symptoms. In addition, the spleen may ruptureduring violence or too much capsule tension, causing it to bleed . This may also occur Upper Left Abdominal Pain. If the stomach is in addition to the discomfort strongly tense and very painful , it could also be a peritonitis ( Peritonitis ) act.

Last but not least, upper abdominal discomfort generally calls for a heart attack . Especially a heart attack in women is often expressed by atypical symptoms, so often just by radiating pain in the upper abdomen. The same applies to inflammation of the pericardium ( pericarditis ). Since the heart is located in the left thorax, the pain may also spread to the left half of the body.

In principle, upper abdominal pain can also originate from the main artery of the body ( aorta), when an aneurysm , ie, an opening of the vessel wall, develops in it. Typical are pain that begin in the back and then radiate into the upper abdomen, among other things . If it is a so-called dissecting aortic aneurysm, the symptoms can also migrate, as it continues to split the vessel wall. According to the amount of decomposition, the pain also moves.

The shingles ( herpes zoster ), a viral disease caused by the chickenpox virus , also often causes discomfort on the upper abdomen, which also has a characteristic rash with red, itchy blisters . This rash extends along the course of a nerve and is usually located only on one side of the body . This condition can be associated with severe pain and burning . Typically, the nerve pain occurs 2-3 days before the rash.

Many diseases can present themselves to patients in different ways. In some cases, even diseases that are actually associated with the chest area can cause upper abdominal pain . Examples include pleurisy , pneumonia , the previously mentioned myocardial infarctionand pneumothorax .

In pneumothorax, air enters the space between the lungs and the pleura , causing the lungs to collapse, Often the air comes from burst Emphysembläschen on the lung surface, but it can also by direct violence on the chest with injury of the pleura reach into the gap (trauma, knife stab, etc.).

In principle, urological and gynecological diseases , which manifest themselves preferentially in the lower abdomen, can radiate into the upper abdomen and should be considered in differential diagnosis.

Aortic aneurysm as a possible cause

  • Extension or aneurysm of the abdominal aorta
  • Perceptible pulsation in the abdominal cavity, when tears of acute abdominal pain due to blood in the abdomen
  • Diagnosis by ultrasound examination of the abdomen
  • Therapy : with a small diameter you can wait and closely check; If the outgrowth is very large, it should be operated on immediately
  • Complications : Tear of the artery with severe blood loss

Spleen disorders (eg splenic rupture) as a possible cause

  • Tear of the spleen capsule, eg due to an accident or a blow in the left abdomen
  • Strongest, sudden pains, which are especially 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 must be removed)
  • Complications : severe blood loss, complications from surgery

Types of Upper Left Abdominal Pain

Upper Left Abdominal Pain with flatulence

In general, all diseases of the gastrointestinal tract can cause flatulence . Since Upper Left Abdominal Pain often originate in the stomach , typical symptoms include irritable stomach , food intolerance , and infectious gastrointestinal diseases . All of these conditions can cause Upper Left Abdominal Pain with flatulence.

The irritable stomach has no previously known organic cause and is usually due to mental stress and stressful situations . Sufferers suffer from recurrent stomach problems , which are often accompanied by heartburn , bloating and flatulence . The symptoms usually last longer than four weeks .

In intolerance to certain foods or food components may also occur to the left upper quadrant pain. For example, in fructose or lactose intolerance (fructose / lactose intolerance). The sugars can not be further degraded due to an enzyme deficiency in the intestine and cause an increased intestinal movement with increased fluid influx into the intestine. This can lead to diarrhea . The sugar residues are increasingly degraded by bacteria , resulting in gases , which then in the form of flatulencecan leave.

Another intolerance reaction is gluten intolerance , also called celiac disease or sprue . In this disease, the gluten, which occurs in many cereals, the trigger of the symptoms. The clinical picture is similar to that of lactose and fructose intolerance.

Infectious gastrointestinal diseases may also manifest as flat stomach pain with flatulence. The increased number of bacteria in the gastrointestinal tract promotes the formation of gases , which in the form of flatulence go out of the intestine.

Also a generally unbalanced diet with high-fat diet can cause gastrointestinal problems that are associated with the corresponding symptoms.

Upper Left Abdominal Pain with nausea

Upper Left Abdominal Pain associated with nausea initially suggests a problem of the stomach . A harmless cause may be, for example, a too rich, too fatty / sugar-rich meal . Nausea is also common in infectious gastrointestinal disorders . Differential diagnoses should always clarify a heart attack . Especially in women, this is often expressed by atypical symptoms, such as upper abdominal pain, back pain, nausea and vomiting. Typical disorders of the stomach, such as a chronic gastritis or a gastric ulcer(Ulcer), can also cause such a complaint.

In general, a stomachache always has to be thought of as a urological disease . Ureteral stones can cause severe abdominal and back pain , as well as severe onset nausea with vomiting . Typically, this pain is unilateral , depending on which ureter is affected, and begin from the level of the navel down and on the flanks. However, they can also radiate into the upper abdomen.

In addition, irritable bowel syndrome may trigger nausea associated with Upper Left Abdominal Pain. Sufferers suffer from recurring stomach problems, which can also be associated with severe nausea.

Also, an inflammation of the pancreas ( pancreatitis ) cause a corresponding symptoms with Upper Left Abdominal Pain and nausea, with the Upper Left Abdominal Pain radiate usually belt-shaped in this disease to the back .

As early pregnancy also manifests in many women as a result of nausea and abdominal pain , this possible cause should not be forgotten either.

Upper Left Abdominal Pain under the costal arch

If the pain occurs just below the costal arch, it can be due to a variety of causes. Just below the left costal arch is the spleen . Diseases of this organ can therefore be associated with the described symptoms. However, it may also be the phenomenon known as stitching , which has its origin in the diaphragm , which is also located approximately at the level of the costal arch.

Flatulence or diseases of the intestine , depending on the position of the intestinal loops and large intestine, may be responsible for the pain below the left costal arch. Infectious diseases such as shingles are also common in the rib cage.
Even diseases of the ribs themselves can be felt as pain under the costal arch. The same applies to complaints that arise on the back and show through the nerves running there on the left upper abdomen below the costal arch.

Upper Left Abdominal Pain after eating

Upper Left Abdominal Pain , which mainly occurs after eating , can be triggered by various factors. A typical clinical picture that accompanies these symptoms is the gastritis ( gastritis ). This may have been caused either autoimmune, bacterial or chemical, ie, for example, by drugs or other harmful substances. If the patient has eaten something, the symptoms usually improve first , but then return very violently shortly thereafter .

In case of an ulcer of the gastric mucosa ( ulcer ), however, it usually comes directly to the food to increasing Upper Left Abdominal Pain . An ulcer of the duodenum may also have meal-related symptoms , however, they will initially better immediately after eating and return only after about 2-3 hours . They often occur at night.

Upper Left Abdominal Pain after eating can, apart from the mucosal lesions mentioned, also be caused by food intolerances . Affected persons suffer from eating foods that contain certain nutrients, often spasmodic abdominal pain, nausea , bloating flatulence and sometimes diarrhea and vomiting .

The same applies to irritable bowel syndrome and irritable bowel syndrome . Affected persons often suffer from diarrhea , nausea and vomiting , as well as bloating and abdominal cramps . Since they are also very sensitive to high-fat foods and then especially after eating suffer from the above symptoms, they should do without them as possible and eat balanced and healthy . It is also important that these patients have enough time to eat, otherwise the symptoms may worsen greatly after the meal.

Upper Left Abdominal Pain in pregnancy

Some women have Upper Left Abdominal Pain as part of their pregnancy . Most of these have a harmless cause and are caused , for example, by the growing child , which increasingly requires space and pushes the surrounding organs to the side. This leads to increasing tension in the abdomen and the abdominal wall is increasingly stretched. This can cause upper abdominal pain.

In addition , the increased pressure in the abdomen promotes heartburn , as the stomach acid can be pushed up the pressure by the esophagus. This may also be manifested by Upper Left Abdominal Pain and a burning sensation behind the sternum .

A serious complication of pregnancy that may be associated with Upper Left Abdominal Pain is HELLP syndrome . This usually occurs towards the end of pregnancy and is characterized by high blood pressure , protein in the urine, liver dysfunction and many other nonspecific symptoms (eg headache, nausea). The Upper Left Abdominal Pain is usually caused by an enlargement of the liver and start on the right side, but can also radiate into the left upper abdomen . The HELLP syndrome can be life-threatening for both mother and child .

Another cause of Upper Left Abdominal Pain during pregnancy may be the so-called hyperemesis gravidarum , or even pregnancy sickness. This leads to Upper Left Abdominal Pain with nausea and vomiting . The pregnancy sickness occurs especially in the first third of the pregnancy.

Of course, Upper Left Abdominal Pain in pregnancy can also be due to causes that can cause these symptoms independently of pregnancy (gastritis, pancreatitis, splenic infarction, etc.).

Figure Upper Left Abdominal Pain

  1. Heart –  Cor
  2. Liver –  hepar
  3. Spleen –  Splen
  4. Stomach  gaster
  5. Pancreas – Pancreas
  6. Large intestine – intestinal tenue
  7. Small intestine – Intestinum crassum
  8. Fallopian tubes – tuba uterina
  9. Ovary – ovary
  10. Uterus – uterus


To find out the underlying cause responsible for the condition, a doctor should be consulted. This is especially true when the pain has been persisting or is very severe . This can use diagnostic methods to determine the causative disorder and initiate appropriate therapy.

In addition to the detailed medical history and a physical examination , in which both the bowel sounds are bugged and the stomach is touched, frequent imaging methods are used. Both with an ultrasound machine and an MRI scan of the abdomen The internal structures can be assessed well and any existing problems can be recognized quickly.

Upper Left Abdominal Pain at the child

There are many different causes that may be responsible for pain on the left costal arch in children. Often, pain in children is much less specific than in adults. Depending on the age of the child , different causes occur with varying probability. Above all, it is important to examine the child’s body for further symptoms . This often leads to clues that allow a conclusion about the cause of the pain.

Upper Left Abdominal Pain in children is usually caused by infectious bowel diseaseor indigestion.
The so-called hypertrophic pyloric stenosis is another typical for the infancy disease, which can cause pain in the left upper abdomen.

Between the ages of 2 months and 3 years , the intussusception of intestinal loops can lead to severe upper abdominal pain.

As certain metabolic and renal diseases are diagnosed for the first time in childhood, urinary tract disorders should also be considered as the cause of the onset of pain.

Strong and prolonged pain of the left upper abdomen should always be examined by a pediatrician to exclude serious clinical pictures, or if necessary, to initiate a suitable therapy.

Upper Left Abdominal Pain
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