Upper abdominal pain accompanied by back pain occurs for a multitude of reasons, due to the large number of organs found in and near the upper abdomen. Causes range from annoying to life-threatening, so medical followup, especially for severe pain, is essential. Diagnosis may require ultrasound or other sophisticated equipment, and treatment may include immediate surgery.
Gallbladder Disease
The gallbladder, a small pear-shaped organ, stores bile produced by the liver, which lies above the gallbladder. Stones can form in the gallbladder and travel to the bile ducts, where they block bile flow. Inflammation and infection, medically known as cholecystitis, can cause severe upper right-sided pain that can spread to the back between the shoulder blades.
Chronic cholecystitis comes and goes, with attacks usually lasting from a few minutes to two to three hours, NetDoctor states. In acute cholecystitis, pain does not let up, and fever, nausea and vomiting may accompany abdominal and back pain. Antibiotics are given for infection, followed by removal of the gallbladder once the inflammation subsides.
Myocardial Infarction
Myocardial infarction, the medical term for a heart attack, can cause upper abdominal pain that radiates to the back and often to the neck, arms or stomach. Nausea, vomiting, lightheadedness and sweating may accompany abdominal symptoms.
Around 1.1 million Americans suffer heart attacks each year, and almost half die, the National Heart Lung and Blood Institute warns. Seeking immediate help could save many, the same source states, since half of those die within the first half hour after a heart attack before they ever reach the hospital.
Pancreatitis
Pancreatitis, inflammation of the pancreas, which produces enzymes that help food digestion and insulin, can cause severe upper abdominal pain that radiates to the back. While mild cases may resolve spontaneously, severe cases can lead to death if not treated, MayoClinic.com states. Nausea, vomiting and abdominal tenderness may also occur.
Diseases that increase the risk of pancreatitis include alcoholism, gallstones, high triglycerides or pancreatic cancer. Chronic pancreatitis can cause pancreatic cancer from chronic inflammation. Respiratory problems, kidney failure, diabetes and malnutrition can all complicate pancreatitis.
Ruptured Spleen
The spleen lies on the upper left side of the abdomen, behind the ribs. Blows to the abdomen can damage or even rupture the spleen. Since the spleen contains a large volume of blood, which passes through it to have old red blood cells removed, blood accumulates quickly in the abdomen after spleen rupture. Severe pain and tenderness in the upper abdomen often radiates to the left shoulder blade in the back.
A severely damaged spleen is often surgically removed. While someone can live without a spleen, he will be more susceptible to infection than most people. Repairing small tears helps preserve immune function, the Merck Manuals Online Medical Library states.
