Qual é a causa da dor no lado esquerdo do umbigo em homens?

Left-sided periumbilical pain—pain located to the left of the navel—can arise from a variety of gastrointestinal, urological, gynecological, or musculoskeletal sources. Common gastrointestinal causes include irritable bowel syndrome (IBS), particularly the constipation-predominant subtype, which often presents with crampy, intermittent discomfort in the lower left abdomen; diverticulitis, especially in older adults, characterized by localized tenderness, low-grade fever, and possible changes in bowel habits; and functional dyspepsia or gas accumulation in the splenic flexure of the colon. Less common but important considerations include colonic neoplasms, ischemic colitis (particularly in patients with cardiovascular risk factors), or inflammatory bowel disease such as ulcerative colitis or Crohn’s disease.

In women of childbearing age, gynecological etiologies must be carefully evaluated—including ovarian cysts (e.g., a ruptured or torsed left ovarian cyst), endometriosis involving the left pelvic sidewall or uterosacral ligaments, or ectopic pregnancy (though this typically causes more severe, acute pain and may be associated with vaginal bleeding and positive pregnancy test). Urinary tract causes—such as left-sided ureteral stones or pyelonephritis—may also refer pain to the periumbilical region, especially early in the course before classic flank or suprapubic localization develops.

Musculoskeletal contributors include rectus abdominis strain, abdominal wall hernias (e.g., Spigelian or epigastric hernias near the lateral umbilical region), or nerve entrapment syndromes like anterior cutaneous nerve entrapment. Rarely, referred pain from thoracic pathology (e.g., splenic infarction or left lower lobe pneumonia) or vascular issues such as mesenteric ischemia should be considered—particularly if pain is sudden, severe, or accompanied by systemic signs like tachycardia, hypotension, or bloody stools.

A thorough clinical evaluation—including detailed history (onset, character, duration, aggravating/alleviating factors, associated symptoms), physical examination (focusing on palpation, rebound tenderness, bowel sounds, and pelvic exam when indicated), and targeted investigations (e.g., CBC, CRP, urinalysis, pregnancy test, abdominal ultrasound, or CT enterography)—is essential to determine the underlying cause. Patients with persistent, worsening, or alarm symptoms—such as unexplained weight loss, nocturnal pain, hematochezia, fever, or vomiting—should undergo prompt further assessment to exclude serious organic pathology.