Differential Diagnosis for Movable Mass in the Right Upper Quadrant
- Single most likely diagnosis
- Gallbladder pathology (e.g., gallstones, cholecystitis): The right upper quadrant is a common location for gallbladder issues, and a movable mass could indicate an inflamed or distended gallbladder.
- Other Likely diagnoses
- Hepatic cyst or tumor: A mass in the liver could be palpable and movable, depending on its size and location.
- Right kidney pathology (e.g., hydronephrosis, renal cyst): Although the kidneys are typically located more posteriorly, a significantly enlarged right kidney could present as a movable mass in the right upper quadrant.
- Intestinal obstruction or volvulus: Although less common, a movable mass could be related to an intestinal issue, such as an obstruction or volvulus, especially if it involves the small intestine or the hepatic flexure of the colon.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic aneurysm (although typically more central and not usually movable): An aortic aneurysm can present with a palpable mass, and missing this diagnosis could be catastrophic.
- Liver abscess: A liver abscess can cause a palpable mass and is a serious condition that requires prompt treatment.
- Perforated viscus (e.g., perforated ulcer, perforated appendix): A perforated viscus can lead to peritonitis and sepsis, making it a critical diagnosis not to miss.
- Rare diagnoses
- Right adrenal gland pathology (e.g., adrenal tumor, pheochromocytoma): Although rare, adrenal gland issues can present with a palpable mass in the right upper quadrant.
- Retroperitoneal tumor (e.g., sarcoma, lymphoma): Tumors in the retroperitoneal space can grow large enough to be palpable and could be mistaken for a movable mass in the right upper quadrant.
- Diaphragmatic hernia: A diaphragmatic hernia can allow abdominal contents to herniate into the thoracic cavity, potentially presenting as a movable mass in the right upper quadrant.