Localization of abdominal pain
For practical reasons, the abdomen is divided into four quadrants and a central portion. To the interest of one or more quadrants correspond certain organs on which to be able to investigate, let’s see them in detail.
Upper left quadrant
Corresponds to the left side . What it contains
The left kidney, the spleen, part of the biliary tract, the left adrenal gland, part of the pancreas, part of the stomach, duodenum and transverse and descending large intestine.
The pathologies affecting this quadrant mainly affect the pancreas and spleen, let’s see some examples:
- Splenomegaly: indicates an increase in the volume of the spleen, following an infection (typically mononucleosis or “kissing disease”) or anemia ;
- Rupture of the spleen: a case not so rare that it follows a trauma of the abdomen;
- Spleen aneurysm: due to dilation of the aorta. This is a real surgical emergency;
- Pathologies affecting the left kidney such as formation of kidney stones, nephritis;
- Pancreatitis : i.e. inflammation of the pancreas;
- Gastroesophageal reflux;
- Presence of air in the intestine (meteorism) .
In reality, many other causes are added to the aforementioned causes, but it should be emphasized that sometimes a pain felt in this area is actually a “referred pain”, ie radiated by organs located in the extra-abdominal area.
Therefore, pain in the left upper abdomen can be a consequence of cardiac, pulmonary, pleural and muscular pathologies.
Right upper quadrant
Corresponds to the right flank where we find the right kidney, liver, gallbladder, pancreas, intestine, duodenum and ascending and transverse colon.
Let’s see the most common causes of abdominal pain here:
- Right kidney disorders: such as stones and infectious or inflammatory processes;
- Gallstones in the gallbladder: These are usually very painful and sometimes treatment requires surgical removal of the gallbladder.
- Cholangitis: it is an inflammatory phenomenon that affects the bile duct;
- Liver disorders: such as hepatitis, liver cancer and hepatic angioma;
- Disorders affecting the stomach: cancer and hiatal hernia (invagination of part of the esophagus into the stomach);
- Intestinal pathologies: fecalomas, ulcers, intestinal obstructions, diverticulitis and the formation of gases that stretch and dilate the intestinal wall are frequent. More rarely the pain is caused by tumor processes;
- Disorders of the pancreas: inflammation (pancreatitis) and tumors.
Sometimes, pain can arise from a disease process that affects thoracic organs, especially the lungs and pleurae (serous membranes that line the lungs).
Right and Left Lower Quadrants
Corresponds to the lower abdomen or groin and contains the lower portion of the left and right kidney, the intestine (duodenum and ascending and descending colon, sigma colon and rectum), in the left portion the vermiform appendix (very important to keep I count if the pain radiates to the navel and leg), the ovaries and part of the spermatic ducts.
Below we illustrate what are the main causes of pain in the lower abdomen :
- Pregnancy : it must be taken into account that during this particular period of a woman’s life this is the area that will host the fetus. Often a constant and very acute abdominal pain here is found in extra-uterine pregnancies, ie pregnancies in which the fetus develops outside the normal uterine site. It is therefore necessary to consult a doctor in case of pain and bleeding;
- Phenomena of ovarian interest : the most frequent cause of pain in the lower part of the abdomen is due to the menstrual cycle and it is very common to experience pain, even quite acute, both during ovulation and during menstruation. However, there are also pathological manifestations that cause pain, such as inflammation and infections of the ovary and tumors;
- Intestinal disorders : the most common forms are chronic intestinal inflammation (Chron’s disease), celiac disease, irritable bowel syndrome , spastic colitis , abdominal colic . Then there is the inflammation of the vermiform appendix (located in the right quadrant) better known as appendicitis . Less common are bowel cancer, intestinal obstructions and diverticulitis;
- Kidney disorders: as described above, these are stones, infections and inflammations.
The one just provided is a fairly complete overview of all the locations where pain and the corresponding affected organ can be felt.
Let us now go into more detail on the methods of diagnosis and the available therapies we have to treat this disorder. Let’s turn the page.