Differential Diagnosis for Elevated GGT and Right Upper Quadrant Pain
Single Most Likely Diagnosis
- Cholelithiasis (Gallstones): Elevated GGT is a sensitive indicator of liver and biliary disease. Right upper quadrant pain is a classic symptom of gallstones, which can cause obstruction of the bile ducts, leading to elevated GGT levels.
Other Likely Diagnoses
- Cholecystitis: Inflammation of the gallbladder, often associated with gallstones, can cause right upper quadrant pain and elevated GGT.
- Hepatitis: Viral or alcoholic hepatitis can cause elevated liver enzymes, including GGT, and may present with right upper quadrant pain.
- Alcoholic Liver Disease: Chronic alcohol consumption can lead to elevated GGT levels and may cause right upper quadrant pain due to liver inflammation or fibrosis.
Do Not Miss Diagnoses
- Bile Duct Obstruction: Obstruction of the bile ducts, which can be caused by gallstones, tumors, or strictures, is a medical emergency that requires prompt diagnosis and treatment. Elevated GGT and right upper quadrant pain are key symptoms.
- Pancreatitis: Although more commonly associated with mid-abdominal pain, pancreatitis can sometimes present with right upper quadrant pain and elevated liver enzymes, including GGT.
- Liver Cancer: Although less common, liver cancer can cause elevated GGT levels and right upper quadrant pain, making it a diagnosis that should not be missed.
Rare Diagnoses
- Primary Biliary Cholangitis (PBC): A chronic autoimmune disease that affects the bile ducts, leading to elevated GGT levels and potentially right upper quadrant pain.
- Primary Sclerosing Cholangitis (PSC): A rare disease that causes inflammation and scarring of the bile ducts, leading to elevated GGT levels and potentially right upper quadrant pain.
- Budd-Chiari Syndrome: A rare condition caused by thrombosis of the hepatic veins, leading to liver congestion, elevated liver enzymes, and potentially right upper quadrant pain.