Published on: 9/30/2024
A wide ranges of diseases can cause left-sided abdominal pain that often involve the underlying organs in that area.
Even when we say left side of the abdomen or left flank, the possible causes often depend on if it is in the upper left or lower left part of the abdomen.
When there is pain in the upper left side of the abdomen, we first consider the organs in that location: such as the spleen, lungs, or kidneys.
Diseases such as splenomegaly (an enlarged spleen), rupture of the spleen and splenic tumors are possible. However, diseases of the spleen itself are not very common.
Cases such as pneumonia and pneumothorax in the left lung can cause pain in the left upper abdomen.
Diseases such as ureteral stones, pyelonephritis, and renal infarction occurring in the left kidney can lead to pain in the upper left side of the abdomen.
The left lower side of the abdomen is mostly taken up by the large intestine with the bladder adjacent to it. Therefore, we consider the diseases of these organs.
One of the most common reasons for pain in the left lower quadrant is constipation. As stool backs up in the large intestine, it can be quite painful. Other less common diseases include enteritis and diverticulitis. They are often accompanied by abnormalities in bowel movements.
When a kidney stone gets stuck near the bladder, the lower left side of the abdomen can ache.
Pain may occur in the left lower area during ovulation or more rarely can come from ovarian bleeding or tumor in the left ovary.
We need to consider diseases of all abdominal organs. In addition to diseases suspected when the left upper or lower abdomen hurts, we also consider diseases of the stomach, duodenum, small intestine, large intestine, pancreas, and aorta.
When there is inflammation or ulcers of the stomach or duodenum, pain often comes before, during or after eating.
Diseases such as aortic dissection and aortitis can be considered, particularly in elderly people or those with other risk factors. Overall, it is quite uncommon.
If there’s a rash in the left abdomen, shingles should be considered. Preceding the rash is often superficial pain that can become severe.
In young and healthy people, musculoskeletal pain is the most common cause of left-sided abdominal pain from muscle strain or overexertion or rib fractures.
(References)
Yew KS, George MK, Allred HB. Acute Abdominal Pain in Adults: Evaluation and Diagnosis. Am Fam Physician. 2023 Jun;107(6):585-596. PMID: 37327158.
Sabo CM, Grad S, Dumitrascu DL. Chronic Abdominal Pain in General Practice. Dig Dis. 2021;39(6):606-614. doi: 10.1159/000515433. Epub 2021 Feb 25. PMID: 33631744.
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Family Medicine, Primary Care Roots Community Health Center, Hippo Education, Kameda Medical Center
Kenji Taylor, MD
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