Left Abdominal Pain: Causes and When to Seek Help

Left abdominal pain and tenderness?

Hello Dr.
Chen,
I underwent a kidney biopsy on March 21 due to lupus erythematosus affecting my left kidney.
Additionally, I recently discovered a teratoma and am currently awaiting surgery.
Over the past week or two, I have occasionally experienced sudden pain or a feeling of pressure in the area to the left of my navel, specifically in the left upper and lower abdomen, approximately three fingerbreadths below the navel, extending towards the hip bone and diagonally up to the front of the hip bone (where abdominal fat begins to accumulate).
The pain is intermittent and varies in location each time.

Moreover, when I press on the left lower abdomen, it feels harder compared to the right side, and even light pressure in the aforementioned area elicits a significant pain response.
Given the recent changes in my abdominal condition, I am uncertain whether this discomfort is due to my sleeping position after the biopsy, which has caused me to twist my waist at a large angle while sleeping, or if it is related to gastrointestinal issues, the kidney biopsy, or even the teratoma.

I would appreciate your advice on what might be causing these symptoms, whether there are self-management strategies I can employ, or which specialty I should consult first.
Thank you!
Ann

Ann, 30~39 year old female. Ask Date: 2024/04/13

Dr. Chen Bozhang reply Family Medicine

Dear Ms.
Ann,
In your letter, you mentioned experiencing intermittent pain and tenderness in the left upper and lower abdomen over the past week or two.
Although you underwent a left kidney biopsy a few weeks ago and have a history of teratoma, these may not be directly related.
There could be many possible causes for your symptoms.
I recommend that you visit a gastroenterology clinic for further evaluation and consultation.
The physician will perform the necessary examinations to identify the cause and address the issue.

Reply Date: 2024/04/13

More Info

Understanding left abdominal pain can be quite complex, especially when it is associated with various underlying conditions. In your case, you have a history of lupus erythematosus and a teratoma, which adds layers of complexity to your symptoms. The left abdominal pain you are experiencing, particularly after a kidney biopsy and with the presence of a teratoma, could stem from several potential causes.

Firstly, the pain you describe as occurring during movement or certain positions may be musculoskeletal in nature. If you have been sleeping in awkward positions or twisting your body frequently, this could lead to muscle strain or irritation of the abdominal wall. Musculoskeletal pain is often sharp and can vary in intensity depending on movement or pressure applied to the area.

Secondly, given your medical history, it is essential to consider the possibility of complications related to your kidney biopsy. Although rare, post-procedural complications such as hematoma formation or infection could manifest as localized pain. If the pain is persistent and worsening, it would be prudent to consult with your healthcare provider to rule out these complications.

Additionally, the presence of a teratoma could also contribute to your symptoms. Teratomas can sometimes cause discomfort or pain depending on their size and location, especially if they exert pressure on surrounding structures. If the teratoma is located near the abdominal cavity, it could potentially cause pain that radiates to different areas of the abdomen.

Moreover, gastrointestinal issues should not be overlooked. Conditions such as irritable bowel syndrome (IBS), constipation, or even diverticulitis can cause left-sided abdominal pain. Given that you mentioned varying pain locations, it might be beneficial to keep a symptom diary to track when the pain occurs, its intensity, and any associated symptoms like changes in bowel habits or urinary symptoms.

In terms of when to seek help, you should definitely consult a healthcare professional if:
1. The pain becomes severe or persistent.

2. You experience additional symptoms such as fever, chills, nausea, vomiting, or changes in bowel or urinary habits.

3. You notice any swelling or tenderness in the abdomen.

4. There are any signs of complications from your previous medical procedures.

In terms of management, if the pain is indeed musculoskeletal, rest, heat application, and over-the-counter pain relief medications may help alleviate discomfort. However, if the pain is related to your underlying conditions or if there are any concerns about complications, further evaluation by a specialist, such as a gastroenterologist or a nephrologist, would be warranted.

In conclusion, while there are several potential causes for your left abdominal pain, it is crucial to consider your medical history and the context of your symptoms. Keeping an open line of communication with your healthcare provider is essential for appropriate diagnosis and management. Regular follow-ups and possibly imaging studies may be necessary to monitor your condition and ensure that any underlying issues are addressed promptly.

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