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The abdomen is divided into nine different anatomical regions. The epigastrium is the name given to the central upper part of the abdomen, and is located between two regions called the left and right hypochondria. The central abdominal section includes the left lumbar, umbilical, and right lumbar regions. The lower section comprises the left ileae, the hypogastric region, and the right ileae. This method of dividing and classifying the region is useful because it provides doctors and surgeons with a way of precisely recording patient symptoms, and of locating structures within the body.
Two organs, and portions of two other organs, are located within the epigastrium. The pancreas, which secretes digestive enzymes, and the duodenum, which is part of the small intestine, are both within this section of the abdomen. Portions of the stomach, where digestion begins, and the liver, which is important in metabolism, detoxification, and digestion, are also located here.
With four major body organs or body structures either partially or fully located here, the epigastrium can be affected by a wide variety of benign or serious health problems. For most of these medical conditions, the most common symptom is simply pain in the epigastrium. Depending on the disease, and the organ involved, a variety of other symptoms may also be present in addition to pain.
One of the most common health problems that affect the epigastrium is gastritis. This condition occurs when the lining of the stomach becomes inflamed, often due to excessive use or alcohol or non-steroidal anti-inflammatory medications. Gastritis may also develop as a result of infection with Helicobacter pylori, a traumatic injury to the epigastric area, anemia, or stress.
Other types of inflammation or infection can affect the epigastric area. These include pancreatitis, which is inflammation of the pancreas, or peritonitis, an inflammation of the peritoneal membrane. This membrane lines much of the abdominal cavity, and because of this peritonitis may affect other sections of the abdomen in addition to the epigastric portion.
Several types of hernias and cancers may also develop in the epigastric portion of the abdomen. Possible cancers include stomach, pancreatic, and liver cancer. Benign tumors called hemangiomas may also develop here. These are clumps of blood vessels which can develop spontaneously in certain organs, most commonly in the liver.
One of the most serious possible causes of epigastric pain is a heart attack. The pain that develops can be mistaken for simple heartburn or indigestion, but it is dangerous to ignore this type of pain. Epigastric symptoms may signify a relatively minor condition such as gastritis or something much more serious, and therefore these symptoms should always be taken seriously.