Differential Diagnosis for Right Upper Abdominal Pain
Single Most Likely Diagnosis
- Gallbladder disease (cholecystitis or cholelithiasis): This is often the most common cause of right upper abdominal pain, especially if it's colicky in nature and associated with nausea, vomiting, and fever. The pain typically occurs after eating fatty foods.
Other Likely Diagnoses
- Peptic ulcer disease: Gastric or duodenal ulcers can cause right upper abdominal pain, especially if the pain is burning in nature and relieved by food or antacids.
- Hepatitis: Inflammation of the liver can cause right upper abdominal pain, jaundice, and elevated liver enzymes.
- Right lower lobe pneumonia: Referred pain from the right lower lobe of the lung can cause right upper abdominal pain, especially if accompanied by cough, fever, and shortness of breath.
- Gastroesophageal reflux disease (GERD): Stomach acid reflux can cause right upper abdominal pain, especially if it's burning in nature and worsens with lying down or eating certain foods.
Do Not Miss Diagnoses
- Appendicitis: Although appendicitis typically presents with right lower abdominal pain, it can occasionally present with right upper abdominal pain, especially if the appendix is retrocecal. Missing this diagnosis can lead to perforation and peritonitis.
- Hepatic abscess: A collection of pus in the liver can cause right upper abdominal pain, fever, and jaundice. Missing this diagnosis can lead to sepsis and death.
- Cholangitis: Infection of the bile ducts can cause right upper abdominal pain, jaundice, and fever. Missing this diagnosis can lead to sepsis and death.
- Pulmonary embolism: A blood clot in the lungs can cause right upper abdominal pain, especially if it's accompanied by shortness of breath, cough, and chest pain.
Rare Diagnoses
- Hepatocellular carcinoma: A rare type of liver cancer that can cause right upper abdominal pain, weight loss, and jaundice.
- Gallbladder cancer: A rare type of cancer that can cause right upper abdominal pain, jaundice, and weight loss.
- Right upper abdominal wall hernia: A rare type of hernia that can cause right upper abdominal pain, especially if it's accompanied by a palpable mass.
- Intra-abdominal shunt malfunction: A rare complication of liver transplantation that can cause right upper abdominal pain, especially if it's accompanied by jaundice and ascites.