Differential Diagnosis for Right Upper Quadrant Pain
- Single most likely diagnosis
- Cholecystitis: This is the most common cause of right upper quadrant pain, often associated with gallstones. The pain is typically constant, severe, and may radiate to the right shoulder or back.
- Other Likely diagnoses
- Biliary colic: This condition occurs when a gallstone temporarily blocks the cystic duct, causing intermittent pain in the right upper quadrant.
- Peptic ulcer disease: Ulcers in the duodenum or stomach can cause pain in the right upper quadrant, especially if the ulcer is located near the pylorus.
- Hepatitis: Inflammation of the liver can cause right upper quadrant pain, along with other symptoms like jaundice and fatigue.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Appendicitis: Although appendicitis typically presents with pain in the lower right quadrant, it can occasionally cause right upper quadrant pain if the appendix is located in a retrocecal position.
- Cholangitis: Infection of the bile ducts can cause severe right upper quadrant pain, jaundice, and sepsis, making it a potentially life-threatening condition.
- Liver abscess: A collection of pus in the liver can cause right upper quadrant pain, fever, and sepsis, requiring prompt diagnosis and treatment.
- Pulmonary embolism: A blood clot in the lungs can cause sudden onset of right upper quadrant pain, especially if the clot is located in the upper lobes.
- Rare diagnoses
- Fitz-Hugh-Curtis syndrome: A rare condition caused by pelvic inflammatory disease, leading to inflammation of the liver capsule and right upper quadrant pain.
- Hepatic artery aneurysm: A rare condition where an aneurysm forms in the hepatic artery, causing right upper quadrant pain and potentially life-threatening bleeding.
- Right upper quadrant pain due to intestinal obstruction or volvulus: Although rare, intestinal obstruction or volvulus can cause right upper quadrant pain, especially if the obstruction is located in the small intestine.