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Differential Diagnosis for Right Upper Quadrant Abdominal Pain

The differential diagnosis for right upper quadrant (RUQ) abdominal pain is broad and includes various conditions affecting the gallbladder, liver, kidneys, and intestines. Here's a categorized list of possible causes:

  • Single Most Likely Diagnosis

    • Gallstones (Cholelithiasis): This is often the most common cause of RUQ pain, especially if the pain is colicky and radiates to the right shoulder. Gallstones can cause obstruction of the cystic duct or common bile duct, leading to pain.

  • Other Likely Diagnoses

    • Cholecystitis: Inflammation of the gallbladder, usually due to gallstones, can cause constant RUQ pain, fever, and leukocytosis.
    • Peptic Ulcer Disease: Ulcers in the duodenum or stomach can cause RUQ pain, especially if the pain is related to eating.
    • Hepatitis: Inflammation of the liver, which can be viral, alcoholic, or drug-induced, can cause RUQ pain, jaundice, and elevated liver enzymes.
    • Pyelonephritis: Infection of the kidney can cause flank pain that may radiate to the RUQ, especially if the right kidney is affected.

  • Do Not Miss Diagnoses

    • Appendicitis: Although appendicitis typically causes lower right quadrant pain, it can occasionally present with RUQ pain, especially if the appendix is retrocecal.
    • Hepatic Abscess: A collection of pus in the liver can cause RUQ pain, fever, and jaundice, and requires prompt antibiotic treatment and drainage.
    • Cholangitis: Infection of the bile ducts can cause RUQ pain, jaundice, and sepsis, and is a medical emergency.
    • Pulmonary Embolism: A blood clot in the lungs can cause RUQ pain if it affects the right lower lobe, and is a life-threatening condition.

  • Rare Diagnoses

    • Hepatocellular Carcinoma: A type of liver cancer that can cause RUQ pain, weight loss, and jaundice.
    • Gallbladder Cancer: A rare cancer that can cause RUQ pain, jaundice, and weight loss.
    • Liver Cysts or Abscesses: Benign or infectious collections in the liver can cause RUQ pain and may require drainage or surgical intervention.
    • Intestinal Obstruction: Blockage of the small or large intestine can cause RUQ pain, nausea, vomiting, and abdominal distension, and requires prompt surgical intervention.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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