The mid upper abdomen contains the lower end of the esophagus, the stomach, the small and large intestine, the liver, the aorta; it is bordering against the lower wall of the heart and deep behind the back wall of the abdomen there is the pancreas. With this in mind it is clear that the physician when faced with a patient who has pain in the mid upper abdomen must be careful not to overlook any of these or other conditions not mentioned. An acute piercing pain going all the way through like a knife may well be an aortic aneurysm that is in the process of rupturing. This is an emergency where swift action is necessary.
The there are the stomach and duodenum related complains from gastritis, a duodenal ulcer or a gastric ulcer. when there is acid reflux the diagnosis of GERD (reflux esophagitis) comes to mind. A hiatus hernia where the diaphragm has an opening to the esophagus that is too big, can cause pain in the mid upper abdomen.
With heart attacks there are many other associated symptoms apart of pain in the mid upper abdomen. There can be cold sweat, pain in the left arm and shortness of breath. Swift action is required. Call 911, if you witness this.
The bowel can get irritable bowel syndrome and in the large intestine ulcerative colitis. The liver can get various conditions like liver abscess (local), liver cirrhosis (involving the entire organ) or a viral infection (hepatitis A, B or C). Liver cancer is a devastating disease and can occur on its own within the liver or through liver metastases from another cancerous organ. Stomach cancer often develops because of chronic inflammation from years of H.pylori infections or from exposure to carcinogens.
Gastroenteritis is common and often short-lived. Lots of vomiting and abdominal pain, but in a few days the patient recovers on its own. This was a quick ride through the world of medicine in the upper mid abdomen (only the most common conditions).