Differential Diagnosis for Right Upper Quadrant Abdominal Pain

Single Most Likely Diagnosis

• Gallbladder disease (cholecystitis or cholelithiasis): This is often the most common cause of right upper quadrant (RUQ) abdominal pain, especially in females. The pain is typically sharp and crampy, and may radiate to the right shoulder or back.

Other Likely Diagnoses

• Peptic ulcer disease: Gastric or duodenal ulcers can cause RUQ pain, especially if the ulcer is located in the duodenum. The pain is often described as burning or gnawing.
• Hepatitis: Inflammation of the liver can cause RUQ pain, and may be accompanied by jaundice, fatigue, and loss of appetite.
• Pyelonephritis: Infection of the kidney can cause flank pain that may radiate to the RUQ. The pain is often accompanied by fever, chills, and dysuria.

Do Not Miss Diagnoses

• Appendicitis: Although appendicitis typically causes lower abdominal pain, it can occasionally cause RUQ pain, especially if the appendix is located in a retrocecal position. Missing this diagnosis can lead to perforation and peritonitis.
• Hepatic abscess: A collection of pus in the liver can cause RUQ pain, fever, and jaundice. If left untreated, it can lead to sepsis and death.
• Cholangitis: Infection of the bile ducts can cause RUQ pain, jaundice, and fever. If not treated promptly, it can lead to sepsis and death.

Rare Diagnoses

• Hepatocellular carcinoma: A rare cause of RUQ pain, often accompanied by weight loss, fatigue, and jaundice.
• Liver metastases: Metastatic disease to the liver can cause RUQ pain, often accompanied by weight loss, fatigue, and jaundice.
• Porphyria: A rare genetic disorder that can cause abdominal pain, including RUQ pain, as well as neurological and psychiatric symptoms.