Differential Diagnosis for 45-year-old Female with Sudden Sharp Right Upper Quadrant Pain
- Single most likely diagnosis
- Biliary colic or cholecystitis: This is the most likely diagnosis given the location and nature of the pain. The sudden onset of sharp pain in the right upper quadrant is often associated with gallbladder pathology, such as a gallstone obstructing the cystic duct.
- Other Likely diagnoses
- Peptic ulcer disease: Although the pain is in the right upper quadrant, peptic ulcers can sometimes present with pain in this location, especially if the ulcer is located in the duodenum.
- Hepatitis: Acute hepatitis can cause right upper quadrant pain, although it is often accompanied by other symptoms such as jaundice and fatigue.
- Right lower lobe pneumonia: Sometimes, pneumonia can cause referred pain to the right upper quadrant, especially if the diaphragm is involved.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Myocardial infarction: Although the pain is in the right upper quadrant, myocardial infarctions can sometimes present with atypical pain locations, and it is crucial to consider this diagnosis, especially in women over 40.
- Pulmonary embolism: Similar to myocardial infarction, pulmonary embolism can present with atypical symptoms, including sharp chest or abdominal pain, and is a potentially life-threatening condition.
- Aortic dissection: This is a rare but life-threatening condition that can cause severe, tearing pain that may radiate to the right upper quadrant.
- Rare diagnoses
- Fitz-Hugh-Curtis syndrome: This is a rare condition characterized by inflammation of the liver capsule and adjacent peritoneal surfaces, often due to pelvic inflammatory disease.
- Right adrenal hemorrhage: This is a rare condition that can cause sudden, severe pain in the right upper quadrant, often accompanied by hypotension and other systemic symptoms.