Flank pain

Background

• This page outlines the general approach to flank pain

Classification by Abdominal pain location

Side-by-side comparison of quadrants and regions.

Chart of commonly reported referred pain sites.

RUQ pain	Epigastric pain	LUQ pain
Flank pain	Diffuse abdominal pain	Flank pain
RLQ pain	Pelvic pain	LLQ pain

Differential Diagnosis

Flank Pain

• Vascular
  • Abdominal aortic aneurysm
  • Renal artery embolism
  • Renal vein thrombosis
  • Aortic dissection
  • Mesenteric ischemia
• Renal
  • Pyelonephritis
  • Perinephric abscess
  • Perinephric hematoma
  • Papillary necrosis
  • Renal cell carcinoma
  • Obstructive uropathy
    • May or may not be due to nephrolithiasis
  • Renal infarction
  • Renal hemorrhage
• Ureter
  • Nephrolithiasis
  • Blood clot
  • Stricture
  • Tumor (primary or metastatic)
• Bladder
  • Tumor
  • Varicose vein
  • Cystitis
• GI
  • Biliary colic
  • Pancreatitis
  • Perforated peptic ulcer
  • Appendicitis (appendix may be pushed to RUQ in pregnancy)
  • Inguinal Hernia
  • Diverticulitis
  • Cancer
  • Bowel obstruction
• Gynecologic
  • Ectopic Pregnancy
  • PID/TOA
  • Ovarian cyst
  • Ovarian torsion
  • Endometriosis
  • Mittelschmerz or benign ovulatory pain
• GU
  • Testicular torsion
  • Epididymitis
• Other
  • Shingles
  • Lower lobe pneumonia
  • Retroperitoneal hematoma, abscess, or tumor
  • Epidural abscess
  • Epidural hematoma
  • Rib contusion/fracture

See Also

• Abdominal pain