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Upper Mid Abdomen

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

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.


Chronic pancreatitis is another condition that is very painful. There is acute and chronic pancreatitis.


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).

Last modified: May 31, 2021

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.


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