Differential Diagnosis for Transaminitis with Right-Sided Abdominal Pain
Single Most Likely Diagnosis
- Gallbladder disease (e.g., cholecystitis, cholelithiasis): This is the most likely diagnosis due to the association between right-sided abdominal pain and liver enzyme elevation, which can occur when a gallstone obstructs the common bile duct, causing liver injury.
Other Likely Diagnoses
- Hepatitis: Various forms of hepatitis (viral, alcoholic, or autoimmune) can cause transaminitis and may be accompanied by right upper quadrant abdominal pain.
- Peptic ulcer disease: Although more commonly associated with epigastric pain, peptic ulcers can occasionally cause right-sided abdominal pain and may lead to liver enzyme elevation if there is significant bleeding or inflammation.
- Budd-Chiari syndrome: This condition, characterized by hepatic vein thrombosis, can cause abdominal pain and liver dysfunction, including transaminitis.
Do Not Miss Diagnoses
- Hepatic artery aneurysm or rupture: A rare but potentially life-threatening condition that requires immediate attention. It can cause severe abdominal pain and liver enzyme elevation.
- Liver abscess: Although less common, a liver abscess can cause right-sided abdominal pain, fever, and transaminitis, and its diagnosis is crucial due to the need for prompt antibiotic treatment and possible drainage.
- Cholangitis: An infection of the bile duct, which can be life-threatening if not treated promptly. It typically presents with the Charcot's triad of fever, jaundice, and abdominal pain.
Rare Diagnoses
- Weil's disease (Leptospirosis): A zoonotic infection that can cause liver dysfunction, including transaminitis, and may be associated with abdominal pain.
- Amyloidosis: A condition characterized by the deposition of amyloid proteins in various organs, including the liver, which can lead to transaminitis and abdominal pain.
- Polycystic liver disease: A rare genetic disorder that can cause cystic changes in the liver, potentially leading to abdominal pain and liver enzyme elevation.