Epigastrium – Anatomy, Organs and Clinical Relevance
The epigastrium is the upper central region of the abdomen, located between the breastbone and the navel. It contains key organs such as the stomach, liver, and pancreas.
Things worth knowing about "Epigastrium"
The epigastrium is the upper central region of the abdomen, located between the breastbone and the navel. It contains key organs such as the stomach, liver, and pancreas.
What Is the Epigastrium?
The epigastrium (also referred to as the epigastric region or upper abdomen) is an anatomical region of the abdomen. It is the central upper area of the belly, situated between the lower end of the breastbone (sternum) and the navel (umbilicus). In the standard nine-region division of the abdomen used in clinical medicine, the epigastrium occupies the central upper field, flanked on either side by the right and left hypochondriac regions.
Anatomical Location and Boundaries
The anatomical boundaries of the epigastrium are defined as follows:
- Superior: Lower margin of the sternum and costal arch
- Inferior: Horizontal plane at the level of the navel
- Lateral: Lateral margins of the rectus abdominis muscle
Organs Located in the Epigastrium
Several important digestive organs and structures are located within or project into the epigastric region:
- Stomach (Gaster): The primary digestive organ that receives and partially digests food
- Liver (Hepar): The left lobe of the liver extends into the epigastrium
- Pancreas: Lies transversely behind the stomach
- Duodenum: The first section of the small intestine
- Gallbladder (Vesica biliaris): Located near the border of the right hypochondrium
- Abdominal aorta and celiac trunk: Major blood vessels supplying abdominal organs
Clinical Significance: Epigastric Pain
Pain or discomfort in the epigastrium, commonly referred to as epigastric pain, is a frequent medical complaint. It can indicate a wide variety of underlying conditions.
Common Causes of Epigastric Pain
- Gastritis: Inflammation of the stomach lining, often associated with nausea and a sensation of pressure
- Stomach ulcer (Peptic ulcer disease): An ulcer in the stomach wall causing burning pain
- Heartburn and Gastroesophageal Reflux Disease (GERD): Acid from the stomach rising into the esophagus
- Pancreatitis: Inflammation of the pancreas, often with belt-like radiating pain
- Cholelithiasis (Gallstones): Gallstones can cause colicky pain in the upper abdomen
- Functional dyspepsia: Digestive discomfort without an identifiable organic cause
- Myocardial infarction (Heart attack): In some cases, a heart attack may present atypically as epigastric pain
When to Seek Medical Attention
Persistent, severe, or newly occurring epigastric pain warrants prompt medical evaluation. The following accompanying symptoms are particularly concerning:
- Sudden, intense pain
- Pain radiating to the back, shoulder, or chest
- Nausea and vomiting with blood
- Fever
- Sweating and shortness of breath (possible heart attack)
Diagnosis
Several diagnostic procedures are available to evaluate complaints related to the epigastrium:
- Physical examination: Palpation of the abdomen to localize the pain
- Blood tests: Detection of inflammatory markers, liver enzymes, and pancreatic enzymes (lipase, amylase)
- Ultrasound (Sonography): Imaging of the abdominal organs
- Upper endoscopy (Esophagogastroduodenoscopy, EGD): Direct visual examination of the esophagus, stomach, and duodenum
- Computed Tomography (CT scan): Detailed cross-sectional imaging for complex findings
References
- Drake, R. L., Vogl, A. W. & Mitchell, A. W. M. (2019). Gray's Anatomy for Students. 4th edition. Elsevier.
- Longo, D. L. et al. (2022). Harrison's Principles of Internal Medicine. 21st edition. McGraw-Hill Education.
- Talley, N. J. & O'Connor, S. (2017). Clinical Examination: A Systematic Guide to Physical Diagnosis. 8th edition. Elsevier Australia.
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