Abdominal pain is one of the most common symptoms in children, and there are many possible causes. The physical exam is an important aspect of the evaluation of children with abdominal pain. The location of the pain can help determine its cause.
Physicians divide the abdomen into four quadrants. Each quadrant contains all or part of different abdominal organs. Based on this information, one can determine which organ is affected by illness or medical condition, which can be producing the pain. Muscles that cover the abdominal wall can also be affected, causing pain in this location.
The left side of the abdomen is made up of two quadrants, the upper and lower. The upper quadrant contains part of the stomach, the spleen and the pancreas. Parts of the small and large intestine cross through this quadrant. The left kidney and adrenal gland are located toward the left flank but can produce pain in the left abdomen. Conditions that affect these organs can produce pain in the left abdomen. For example, stomach acid reflux and ulcers can present with upper left abdominal pain. Pancreatitis (an inflammation of the pancreas), kidney stones and infections, or trauma to the spleen can also present with pain in the left abdomen.
The lower left quadrant contains the distal colon and rectum. Inflammatory bowel disease, a chronic condition of the intestine, can cause pain in this area. Conditions affecting the pelvic organs can also occur, with pain in the lower abdomen. For example, torsion of the ovaries or inguinal hernias can manifest this way.
One of the most common causes of left abdominal pain in children is constipation. This condition is caused by diets that don't contain enough fiber or water. It's important for children to consume a balanced diet, with recommended amounts of fruits and vegetables. The recommendation for water intake is about eight 8 oz. glasses of water a day, or about one cup for every 20 lbs. of body weight.
Left-side abdominal pain can be the initial presentation for serious illnesses, including pancreatitis, inflammatory bowel disease and kidney stones. It's important to contact a health care provider if the pain is continuous, sharp, worsening over a short period, or is accompanied by other symptoms including bloody diarrhea, pain or bleeding when urinating, vomiting or inability to stool or void.
- Nelson Textbook of Pediatrics, Robert M. Kliegman MD, Richard E. Behrman MD, Hal B. Jenson MD, Bonita M.D. Stanton MD, 18th Edition 2007
- Medline Plus