33 سنوات
I have severe pain on the left side of my abdomen that I've had for weeks now and the pain is radiating to my back now. I've seen a few doctors but they couldn't find any specific reason for my pain.
23 أكتوبر 2014
I will try to elicit the most likely causes of left-sided abdominal pain, taking into account your age and gender. You still however need to refer to a physician for proper work-up.
Organs in the Left Side Abdomen
Organs in the Upper Left Side Abdomen
The organs found in the upper left side abdomen include the spleen, a portion of the bowel or large intestines, part of the pancreas, a portion of the stomach and the left kidney as well as the skin, muscles and left lower ribs that cover these organs. Additionally, the top portion of the left ureter (the tube that connects the kidneys to the bladder), the top of the left lung's behind and the left side's adrenal gland (a small gland found on top of each kidney and that secretes cortisol, the stress hormone, among other things).
Organs in the Lower Left Side Abdomen
Here the lower edge of the kidney on the left side, the left ureter, a portion of the large bowel, the sigmoid colon, and a portion from the urinary bladder, large blood vessels and nerves and in women, the left tube and ovary, are located.
It is important to note that if a structure is not found within the abdomen, it does not necessarily mean that it cannot cause pain in this area.
When trying to identify the cause of the pain, the following questions need to be answered:
• The exact location of the pain.
• The time of onset of pain.
• If it started suddenly or gradually.
• Continuous or intermittent.
• Nature of the pain - stabbing, burning, gripping, etc.
• What makes it better or worse - eg, food, position, medication.
• Where it radiates to (in your case, it’s to the back).
• Appetite: any nausea or vomiting.
• Any fever symptoms.
• Bowels: ability to pass stool/flatus.
• Any blood, mucus, or melena (black stools; indicate blood from the stomach), and the consistency of stool (hard, soft, loose etc.)
• Timing of last menstrual period; menstrual history, irregular vaginal bleeding and form of contraception.
• Vaginal discharge.
• Urine: any urinary symptoms present.
• Smoking and drinking history.
• Note past medical history.
• Medication.
Causes of acute left-sided abdominal pain are numerous and various, and include:
1- Gastrointestinal causes
• Gastroenteritis: causes more generalized abdominal pain.
• Constipation:
• Diverticulitis (a common digestive disease which involves the formation of pouches (diverticula) within the bowel wall): over 90% of diverticular disease involves the sigmoid colon and therefore diverticulitis most commonly presents with left-sided abdominal pain.
• Left inguinal/femoral hernia: an incarcerated left inguinal or femoral hernia may present as left-sided abdominal pain. There will be tenderness and a protruding mass over the hernial orifice, and symptoms and signs of bowel obstruction.
• Ectopic pregnancy in the left Fallopian tube
• Threatened or complete miscarriage: if a pregnancy test is positive and there is a history of bleeding, always refer for an ultrasound scan to exclude an abortion.
• Pelvic inflammatory disease (PID): typically associated with vaginal discharge. More likely in the context of multiple sexual partners, a history of PID and if an intrauterine device is in situ.
• Ovarian torsion: rotation of the ovary to such a degree as to occlude the ovarian artery and/or vein and interrupt blood flow to the affected ovary. It usually occurs when an ovary is enlarged by a cyst. Diagnosis can be difficult. There may be adnexal tenderness. Ultrasound scan may show the abnormal ovary.
• Fibroid (benign muscle growths in the uterus) that degenerate.
3- Urological causes
• Renal colic: due to kidney stones. Pain is usually described as intermittent and 'shooting'. A stone may cause microscopic hematuria (blood that is only seen under the microscope). Ultrasound scanning is a good diagnostic technique.
• UTI: urinary frequency (passing urine frequently), dysuria (pain/burning/discomfort upon passing urine), hematuria, urgency (urge to pass urine while only few drops come out)and smelly urine may raise this as a differential diagnosis.
One more possible cause is zona or shingles, caused by the virus Herpes zoster: usually a characteristic rash. Before the rash appears the skin can be tender.
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