What is in the left hypochondrium
Below the left costal arch are located most of the stomach, the tail of the pancreas, the spleen, the splenic flexure of the colon, the left kidney and the adrenal gland, and above the diaphragm is the lower lobe of the left lung. Pain from these organs is felt similarly because the sensory fibers follow common paths. Therefore, the doctor focuses not only on the location, but also on the nature of the pain, its connection with food, body position, breathing and stool, as well as accompanying signs.
- Stomach and its outlet section
- Tail of the pancreas
- Spleen
- Splenic flexure of the colon
- Left kidney
- Lower lobe of the left lung and pleura
Stomach and intestines
The most common group of reasons. With gastritis and functional dyspepsia, the pain is aching, associated with food, accompanied by heaviness, nausea and early satiety. A stomach ulcer may cause more pronounced pain on an empty stomach or an hour after eating. A separate and very common cause is the accumulation of gas in the splenic flexure of the colon: the pain is stabbing or bursting, intensifies before stool and noticeably weakens after the passage of gas. With irritable bowel syndrome, the pain varies in intensity and is associated with stool.
- Gastritis and functional dyspepsia
- Gastric ulcer
- Accumulation of gases in the splenic flexure
- Irritable bowel syndrome
- Constipation and colon fullness
- Diverticular disease
Pancreas and spleen
Inflammation of the pancreas usually causes intense pain in the upper abdomen, radiating to the back and girdling, with nausea and vomiting that does not bring relief. Such pain requires urgent examination. The spleen enlarges during infections, blood diseases and portal hypertension: then there is heaviness under the ribs and a feeling of early satiety. A special situation is a rupture of the spleen after an abdominal injury: the pain increases, pallor, weakness, and a drop in pressure appear. This condition is life-threatening and requires calling 103 for help.
- Acute and chronic pancreatitis
- Enlarged spleen due to infections and blood diseases
- Splenic infarction
- Splenic rupture after injury
- Pancreatic cysts
When it's not your stomach that hurts
Pain in the left hypochondrium does not always come from the abdominal cavity. Intercostal neuralgia and muscle tension cause pain, which intensifies when turning, taking a deep breath and palpating a specific point. Pleurisy and inflammation of the lower lobe of the lung add cough, fever and the connection of pain with breathing. A dangerous cause is myocardial infarction of the lower wall, which sometimes manifests itself as pain in the upper abdomen, nausea and sweating. Therefore, when severe pain occurs for the first time with shortness of breath or sweating, an ECG is done.
- Intercostal neuralgia
- Muscle strain and rib injury
- Pleurisy and pneumonia
- Shingles before the rash appears
- Myocardial infarction with pain in the upper abdomen
- Left kidney stones
Examination and what to do
The doctor clarifies when the pain appeared, what is associated with it, whether there is fever, vomiting, changes in stool and weight. Basic examination includes examination, general and biochemical blood tests, amylase and lipase, and ultrasound of the abdominal cavity. For pain associated with eating, gastric endoscopy is prescribed; if an intestinal cause is suspected, a colonoscopy is prescribed. Before being examined by a doctor, it is not recommended to heat the stomach or take painkillers, which will erase the picture. If there is sudden intense pain, you need to call for help without waiting until the morning.
- General and biochemical blood test
- Amylase and lipase
- Ultrasound of the abdomen and spleen
- EGD in relation to pain and food
- ECG for shortness of breath and sweating
- Do not apply heat to the abdomen or take painkillers before the examination.