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DD of epigatric pain (ChatGPT) - Coggle Diagram
DD of epigatric pain
(ChatGPT)
Gastrointestinal (GI)
& hepatobiliary Systems
Stomach
Gastritis
Inflammation of the stomach lining, often caused by H. pylori, NSAIDs, or alcohol.
Symptoms: Burning epigastric pain, nausea, bloating, worsens with food.
Peptic Ulcer Disease (PUD)
Ulceration of the stomach or duodenal lining, often due to H. pylori or NSAIDs.
Symptoms: Gnawing epigastric pain, worse at night, may improve with antacids.
Gastric Cancer
Malignant growth in the stomach, often asymptomatic early.
Symptoms: Epigastric discomfort, early satiety, weight loss, nausea.
Duodenum
Duodenal Ulcer
Ulceration in the duodenum, usually caused by H. pylori infection.
Symptoms: Epigastric pain, often relieved by eating, pain returns a few hours post-meal.
Esophagus
Gastroesophageal Reflux Disease (GERD)
Acid reflux causing esophageal irritation.
Symptoms: Burning epigastric and retrosternal pain, regurgitation, worse after meals.
Small Intestine
Celiac Disease
Autoimmune reaction to gluten affecting small intestine.
Symptoms: Chronic epigastric pain, bloating, diarrhea, malabsorption signs.
Pancreas
Pancreatitis (Acute and Chronic)
Inflammation of the pancreas, acute usually from gallstones or alcohol.
Symptoms: Severe, constant epigastric pain radiating to the back, nausea, vomiting.
Pancreatic Cancer
Malignancy of the pancreas, typically advanced when symptomatic.
Symptoms: Persistent epigastric pain, weight loss, jaundice.
Gallbladder and Biliary Tract
Cholecystitis
Inflammation of the gallbladder, often due to gallstones.
Symptoms: Right upper quadrant pain that can radiate to epigastrium, fever, nausea.
Biliary Colic
Pain from gallstone movement, obstructing the cystic or common bile duct.
Symptoms: Severe epigastric pain after eating fatty foods, radiates to back.
Liver
Hepatitis (Viral, Alcoholic, Non-Alcoholic Fatty Liver Disease)
Inflammation of the liver from various causes.
Symptoms: Right upper quadrant or epigastric pain, jaundice, fatigue.
Liver Abscess
Accumulation of pus in the liver, often from bacterial or parasitic infection.
Symptoms: Epigastric/right upper quadrant pain, fever, malaise.
Liver Cirrhosis (Compensated and Decompensated)
Advanced fibrosis from chronic liver disease.
Symptoms: Vague epigastric pain, ascites, jaundice, variceal bleeding.
Cardiovascular System
Heart
Myocardial Infarction (especially Inferior Wall MI)
Heart attack affecting the inferior wall can present as epigastric pain.
Symptoms: Epigastric discomfort, nausea, sweating, shortness of breath.
Angina Pectoris
Chest pain from reduced blood flow to the heart, can radiate to epigastrium.
Symptoms: Epigastric pain with exertion, relieved by rest or nitroglycerin.
Aorta
Abdominal Aortic Aneurysm (AAA)
Dilation of the aorta in the abdominal section, may present as epigastric pain if large or leaking.
Symptoms: Pulsating abdominal mass, severe epigastric/back pain if rupturing, hypotension.
Pulmonary System
Lower Lobe Pneumonia
Infection of lung tissue near the diaphragm.
Symptoms: Pleuritic chest pain that may refer to the epigastric area, fever, cough.
Pulmonary Embolism
Blood clot in the lungs, occasionally presents with epigastric pain if infarction occurs.
Symptoms: Sudden onset pain, dyspnea, tachycardia, hypoxia.
Renal/Genitourinary System
Kidneys and Ureters
Pyelonephritis
Kidney infection, commonly due to bacteria.
Symptoms: Flank/epigastric pain, fever, dysuria, nausea.
Nephrolithiasis (Kidney Stones)
Stones in the kidney or ureter, can cause referred epigastric pain.
Symptoms: Severe colicky pain radiating from flank to epigastrium, hematuria.
Neurological and Musculoskeletal System
Spinal Conditions
Thoracic Spine Pathology (e.g., Herniated Disc)
Compression or irritation of nerves that refer pain to the epigastrium.
Symptoms: Epigastric pain that worsens with movement, no GI symptoms.
Abdominal Wall
Muscle Strain or Hernia
Injury or herniation of abdominal muscles, can mimic internal pain.
Symptoms: Tenderness to palpation, worse with movement or pressure.
Metabolic and Systemic Causes
Diabetic Ketoacidosis (DKA)
Metabolic acidosis from uncontrolled diabetes.
Symptoms: Nausea, vomiting, epigastric pain, fruity breath, dehydration.
Porphyria
Rare genetic disorder affecting heme metabolism.
Symptoms: Severe episodic abdominal pain, neuropsychiatric symptoms.
Functional or Idiopathic Disorders
Functional Dyspepsia
Chronic, idiopathic upper abdominal pain or discomfort.
Symptoms: Persistent or recurring epigastric pain, fullness, no organic cause found.