From the Guidelines
Upper right abdominal swelling is most commonly caused by liver disorders, gallbladder problems, or other conditions affecting organs in that area, and prompt medical attention is necessary for proper diagnosis and treatment. The causes of upper right abdominal swelling can be varied, including:
- Liver disorders such as hepatitis, cirrhosis, fatty liver disease, or liver cancer, which can cause the liver to enlarge 1
- Gallbladder problems like cholecystitis (inflammation) or gallstones, which can create swelling and pain 1
- Right-sided heart failure leading to fluid buildup
- Kidney infections or cysts if the kidney is positioned higher
- Pancreatic inflammation or tumors extending to the right side
- Abdominal muscle hernias
- Intestinal blockages or inflammatory bowel conditions, which may also present with localized swelling
- Fluid accumulation (ascites) from liver disease or cancer, which can cause generalized abdominal distension that appears more prominent on the right side
According to the most recent guidelines, ultrasound (US) is the first choice of investigation for biliary symptoms or right upper quadrant abdominal pain 1, and it is very accurate at diagnosing or excluding gallstones with reported accuracy of 96% for detection of gallstones. However, if complications of acute cholecystitis are suspected, US remains the first choice of investigation, and CT with IV contrast is preferable and usually appropriate when CT is obtained for subsequent imaging 1.
It is essential to seek medical attention promptly if you experience upper right abdominal swelling, especially if accompanied by pain, fever, jaundice, or changes in bowel habits, for proper diagnosis through physical examination, blood tests, and imaging studies like ultrasound or CT scan 1. Early diagnosis is crucial as many of these conditions require specific treatments ranging from antibiotics for infections to surgical intervention for structural problems.
From the Research
Causes of Upper Right Abdominal Swelling
The causes of upper right abdominal swelling can be varied and complex. Some possible causes include:
- Gallbladder issues, such as gallstones 2
- Liver problems, including infections or inflammation 2
- Pancreatic disorders, such as pancreatitis 2
- Musculoskeletal issues, including strain or injury to the muscles of the thorax 2
- Systemic and extra-abdominal diseases, including metabolic/endocrine causes, hematologic causes, inflammatory causes, infectious causes, functional causes, and neurogenic causes 3
Specific Conditions
Certain conditions can cause upper right abdominal swelling, including:
- Gastric perforation, although this is more commonly associated with the right lower quadrant 4
- Benign ovarian tumors, which can cause acute abdominal syndrome 5
- Functional abdominal bloating and distension, which can be caused by food intolerances, previous infections, disordered visceral sensation, delayed intestinal transit, or abnormal viscero-somatic reflux 6
Diagnostic Considerations
Diagnosing the cause of upper right abdominal swelling can be challenging, and may require a combination of physical examination, radiological procedures, and laboratory tests 2, 5. In some cases, laparotomy may be necessary to diagnose and treat the underlying condition 5.