Differential Diagnosis
- Single most likely diagnosis
- Cholecystitis: This is the most likely diagnosis given the context of the question, which directly mentions it as an option. Cholecystitis, inflammation of the gallbladder, is a common condition that can present with right upper quadrant abdominal pain, fever, and leukocytosis, making it a plausible choice based on typical clinical presentations.
- Other Likely diagnoses
- Hepatocellular carcinoma: While less directly implied by the question, hepatocellular carcinoma (liver cancer) could be considered if the patient has risk factors such as hepatitis B or C, alcohol use, or cirrhosis. It might present with abdominal pain, weight loss, and liver dysfunction.
- Mixed hepatocellular and cholestatic conditions: Conditions that affect both the liver parenchyma and the biliary system could be considered, especially if there are symptoms or lab findings suggestive of both liver dysfunction and biliary obstruction or inflammation.
- Do Not Miss diagnoses
- Pancreatitis: Although not directly mentioned, pancreatitis is a critical diagnosis to consider due to its potential severity and the overlap of symptoms with cholecystitis, such as abdominal pain.
- Liver abscess or pyogenic liver abscess: These conditions can present with fever, right upper quadrant pain, and can be life-threatening if not promptly treated.
- Biliary obstruction (e.g., due to stones or tumors): Obstruction of the biliary tree can lead to severe consequences, including cholangitis, which is an infection of the biliary system and can be life-threatening.
- Rare diagnoses
- Primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC): These are chronic liver diseases that affect the bile ducts and can present with cholestatic liver function tests. They are less common and might not be the first consideration but should be kept in mind, especially if other diagnoses are ruled out.
- Metastatic disease to the liver: While not directly related to cholecystitis or hepatocellular carcinoma in a straightforward manner, metastatic disease can cause a wide range of symptoms, including abdominal pain and liver dysfunction, and should be considered in patients with a known history of cancer.