• A. Foregut structures, i.e. stomach, pancreas, liver, duodenum, gallbladder, spleen ✓
  • B. Midgut structures, i.e. small bowel, ascending colon
  • C. Hindgut structures, i.e. rectum, large bowel, adnexa, urinary bladder, uterus, prostate


Pain in the epigastric region typically arises from foregut structures. The epigastric region is located in the upper central part of the abdomen, just below the sternum. Various organs in the foregut can cause pain in this area:

  1. Stomach: Gastritis, peptic ulcers, and gastritis can cause epigastric pain.
  2. Pancreas: Pancreatitis, inflammation of the pancreas, can lead to severe epigastric pain that may radiate to the back.
  3. Liver: Liver conditions such as hepatitis or liver congestion can cause discomfort in the epigastric region.
  4. Duodenum: Duodenal ulcers or inflammation of the duodenum can result in epigastric pain.
  5. Gallbladder: Gallstones or inflammation of the gallbladder (cholecystitis) can cause pain that is often felt in the epigastric region.
  6. Spleen: Enlargement or rupture of the spleen can lead to pain in the left upper quadrant that may extend to the epigastric region.

Therefore, when experiencing pain in the epigastric region, it is essential to consider these foregut structures as potential sources of the discomfort.

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