If you want to be thorough and not forget anything, use both the anatomic framework and the VINDICATED MEN framework.

Causes of left upper quadrant (LUQ) abdominal pain

The spleen lives there. Lower lobes of the lungs can be referred here.

  • Splenomegaly – Pain or discomfort in LUQ, left shoulder pain, and/or early satiety.
  • Splenic infarct (severe LUQ pain).
  • Splenic abscess (associated with fever and LUQ tenderness) – Also called subdiaphragmatic or subphrenic abscess
  • Splenic rupture
  • Lungs: Pneumonia, empyema

 

Causes of epigastric abdominal pain

Heart pain can be referred there. The Stomach, the pancreas, and proximal duodenum live there.

  • Dyspepsia (functional dyspepsia, ulcer, GERD)
  • Acute myocardial infarction
  • Acute pancreatitis
  • Chronic pancreatitis
  • Peptic ulcer disease ( 2/2 to NSAIDs, H.pylori, etc)
  • Gastroesophageal reflux disease
  • Gastritis/gastropathy
  • Gastroparesis (associated with n/v. abd. pain, early satiety, postprandial fullness, and bloating)

 

Causes of right upper quadrant (RUQ) abdominal pain

The liver, gallbladder, biliary tree, and the hepatic portal system live there. Lower lobes of the lungs can be referred here.

Biliary

  • Biliary colic
  • Acute cholecystitis
  • Gallbladder disease (other)
  • Acute cholangitis
  • Sphincter of Oddi dysfunction

Hepatic

  • Acute hepatitis/chronic hepatitis
  • Perihepatitis (Fitz-Hugh-Curtis syndrome)
  • Liver abscess
  • Budd-Chiari syndrome
  • Portal vein thrombosis

Causes of diffuse or non-specific abdominal pain

  • Medications (NSAIDs, iron, etc).
  • Psychiatric (depression, sexual abuse, etc).
  • Viral gastroenteritis
  • Other infection, e.g. Giardia
  • Irritable bowel syndrome
  • Constipation
  • Hernia
  • Sickle Cell Crisis
  • Bowel obstruction (n/v, crampy abd. pain, and obstipation).
  • Intussusception
  • Perforated viscus, peritonitis. Perforation of the G.I. tract (severe abd. pain, especially after a procedure)
  • Acute mesenteric ischemia
  • Chronic mesenteric ischemia
  • Mesenteric lymphadenitis
  • Mesenteric panniculitis
  • Inflammatory bowel disease (ulcerative colitis/Crohn disease)
  • Spontaneous bacterial peritonitis
  • Dialysis-related peritonitis
  • Colorectal cancer
  • Other malignancy
  • Celiac disease
  • Diabetic Ketoacidosis
  • Adrenal insufficiency
  • Foodborne illness / Food poisoning
  • Diverticulosis
  • Lactose intolerance
  • Carbohydrate malabsorption
  • Herpes zoster

Causes of lower quadrant abdominal pain

The appendix, colon, kidneys, ureters, bladder live here. So are the ovaries, fallopian tubes, uterus, cervix, and vagina in a female.

  • Appendicitis
  • Diverticulitis
  • Kidney stones (Nephrolithiasis)
  • Pyelonephritis
  • Acute urinary retention / Bladder distension
  • Cystitis / Urinary tract infection
  • Infectious colitis

Pelvic causes of abdominal pain in women

  • Ectopic pregnancy
  • Pregnancy Complication
  • Pelvic inflammatory disease
  • Ovarian torsion
  • Ruptured ovarian cyst
  • Endometriosis
  • Acute endometritis
  • Chronic endometritis
  • Leiomyomas (fibroids)
  • Adenomyosis
  • Ovarian hyperstimulation
  • Ovarian cancer
  • Ovulatory pain (Mittelschmerz)
  • Dysmenorrhea

 

Less common causes of abdominal pain

  • Abdominal aortic aneurysm (AAA)
  • Ruptured AAA
  • Abdominal compartment syndrome
  • Abdominal migraine
  • Abdominal epilepsy
  • Acute intermittent porphyria
  • Angioedema due to ACE-inhibitors
  • Hereditary angioedema
  • Celiac artery compression syndrome
  • Superior mesenteric artery syndrome.
  • Chronic abdominal wall pain
  • Colonic pseudo-obstruction (acute or chronic)
  • Eosinophilic gastroenteritis
  • Epiploic appendagitis
  • Familial Mediterranean fever
  • Helminthic infections
  • Hypercalcemia
  • Hyperparathyroidism
  • Hypothyroidism and Hyperthyroidism
  • Lead poisoning
  • Meckel’s diverticulum
  • Narcotic bowel syndrome
  • Pseudoappendicitis
  • Pulmonary etiologies
  • Rectus sheath hematoma
  • Renal infarction
  • Rib pain
  • Sclerosing mesenteritis
  • Somatization
  • Wandering spleen
  • iliocostal friction syndrome
  • Black Widow Spider Bite
  • Leukemia
  • Eosinophilic gastroenteritis
  • Periarteritis nodosa
  • Radiculopathy
  • Tabes dorsalis
  • Diabetes
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