The mid upper abdomen contains a lot of structures. There is the lower end of the esophagus, the stomach, the small and large intestine, the liver and the aorta. This borders against the lower wall of the heart. Deep behind the back wall of the abdomen there is the pancreas.
Aortic aneurysm
With this in mind it is clear that the physician facing a patient who has pain in the mid upper abdomen must be careful not to overlook any of these or other conditions. An acute piercing pain going all the way through like a knife may well be a rupturing aortic aneurysm. This is an emergency where swift action is necessary.
Stomach and duodenum
There are symptoms originating from the stomach and duodenum. Conditions like gastritis, a duodenal ulcer or a gastric ulcer. when there is acid reflux (the diagnosis of GERD or reflux esophagitis) come 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.
Mid abdominal pain
Heart attack
With heart attacks there can be many other symptoms apart of pain in the mid upper abdomen. The patient has cold sweats, pain in the left arm and shortness of breath. Swift action is necessary. Call 911, if you witness this.
Bowel problems, liver problems and stomach pain
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.
Pancreatitis
Chronic pancreatitis is another condition that is very painful. There is acute and chronic pancreatitis.
Gastroenteritis
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).
