Differential Diagnosis for Right Upper Quadrant Abdominal Swelling
Single Most Likely Diagnosis
- Gallbladder disease (e.g., cholecystitis, cholelithiasis): This is the most common cause of right upper quadrant abdominal pain and swelling, often related to gallstones or inflammation of the gallbladder.
Other Likely Diagnoses
- Hepatitis: Inflammation of the liver can cause right upper quadrant swelling and pain, often due to viral or alcoholic hepatitis.
- Peptic ulcer disease: Although more commonly associated with epigastric pain, peptic ulcers can sometimes cause right upper quadrant pain and swelling.
- Liver abscess or cyst: A collection of pus or fluid in the liver can cause swelling and pain in the right upper quadrant.
- Pyelonephritis or perinephric abscess: Infection of the kidney or surrounding tissue can cause right upper quadrant pain and swelling.
Do Not Miss Diagnoses
- Appendicitis (with atypical presentation): Although appendicitis typically presents with lower right quadrant pain, it can occasionally present with right upper quadrant pain, especially if the appendix is retrocecal.
- Hepatic tumor or metastasis: A tumor in the liver can cause swelling and pain in the right upper quadrant, and is important to diagnose due to its potential impact on prognosis and treatment.
- Cholangitis: Infection of the bile ducts can cause severe right upper quadrant pain, jaundice, and sepsis, making it a critical diagnosis not to miss.
- Liver rupture or hemorrhage: A rare but life-threatening condition that requires immediate diagnosis and treatment.
Rare Diagnoses
- Right upper quadrant lymphoma: A rare cause of swelling and pain in the right upper quadrant, often associated with lymphoma or other hematologic malignancies.
- Right upper quadrant pancreatic tumor: A rare cause of right upper quadrant pain and swelling, often associated with pancreatic cancer or other pancreatic tumors.
- Right upper quadrant splenosis: A rare condition where splenic tissue implants in the right upper quadrant, often after splenic injury or surgery.
- Right upper quadrant Castleman disease: A rare lymphoproliferative disorder that can cause swelling and pain in the right upper quadrant.