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Forum Name: Gastroenterology Topics

Question: pain in the lower left abdomen


 bbqporkbun - Mon Jun 14, 2010 11:40 am

Hello, thanks in advance for your help.

I have pain in the lower left abdomen, right by the last rib. if i don't move i don't feel much but the pain comes when i shock the body (jump for example), press in that area, or take a deep breath. its been 2 days now.

I am in the middle of a vacation and am wondering what that may be.

Thanks.
 Dr.M.Aroon kamath - Sun Jul 04, 2010 1:22 pm

User avatar Hi,
I understand that you are on a vacation. Have you been involved in any sort of unaccustomed physical activity (trekking, surfing, rowing and the like)? Did you feel feverish? Any throat pain or cough?

The probable cause could be:
Costochondritis (Tietze's Syndrome) involving the last costal cartilage (although the 12th ribs have no costal cartilages): due to inflammation of the costal cartilage & costo-chondral junction. The cause is unclear but, repetitive microtrauma as a result of activities that cause repeated micro-damage to the cartilage which then leads to inflammation.

This commonly occurs in children, adolescents & young adults. Has also been reported as an overuse injury in athletes. In particular, this condition has been observed in competitive rowers. can also occur following overt trauma (seat belt injuries in motor vehicle collisions).

Symptoms: pain that is usually worsened by activity or exercise. Very often, the pain is worsens during a deep breath. Pain may radiate to the arms or shoulder.

Signs: local tenderness over the costo-chondral junction and absence of respiratory signs.

Management: consists of rest, local heat (hot packs) and NSAIDs.

Differential diagnosis: pleurisy should be considered in any chest pain wherein the pain is aggravated by deep breathing, coughing or sneezing. Generally accompanied by fever, cough or other respiratory signs and symptoms. The other condition to exclude is a muscle strain, which could have occurred due to especially, a twisting force.
Best wishes!

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