Differential Diagnosis for Right Upper Quadrant Pain after Eating
- Single most likely diagnosis
- Cholecystitis or cholelithiasis (gallstones): This is the most common cause of right upper quadrant pain that worsens after eating, particularly fatty foods. The pain is often severe and may radiate to the right shoulder.
- Other Likely diagnoses
- Peptic ulcer disease: Ulcers in the stomach or duodenum can cause pain in the right upper quadrant, especially after eating.
- Gastroesophageal reflux disease (GERD): While more commonly associated with heartburn, GERD can also cause right upper quadrant pain, especially after large or fatty meals.
- Hepatitis: Inflammation of the liver can cause right upper quadrant pain, and eating can exacerbate the discomfort.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute pancreatitis: Although the pain is typically more central, it can radiate to the right upper quadrant. Missing this diagnosis can lead to severe complications.
- Liver abscess or tumor: These conditions can cause right upper quadrant pain and are critical to diagnose early for effective treatment.
- Pneumonia (right lower lobe): Referred pain from the right lower lobe of the lung can cause right upper quadrant abdominal pain, especially if the diaphragm is involved.
- Rare diagnoses
- Fitz-Hugh-Curtis syndrome: A rare condition where the liver capsule is inflamed, often due to pelvic inflammatory disease, causing right upper quadrant pain.
- Intestinal obstruction: Although more commonly associated with diffuse abdominal pain, an obstruction in the small intestine can cause localized pain in the right upper quadrant.
- Right upper quadrant tumors (e.g., hepatocellular carcinoma, metastatic disease): These are less common causes of pain in this area but are important to consider, especially in patients with risk factors.