Differential Diagnosis for 60 year old male with right upper quadrant abdominal pain
- Single most likely diagnosis
- Cholecystitis: This is a common cause of right upper quadrant abdominal pain in adults, especially in older individuals. The pain is often constant and may radiate to the right shoulder or back. Risk factors such as gallstones, which are more common with increasing age, support this diagnosis.
- Other Likely diagnoses
- Biliary colic: This condition is caused by temporary obstruction of the cystic duct or common bile duct, often by a gallstone. It presents with intermittent, severe right upper quadrant pain.
- Peptic ulcer disease: Although peptic ulcers can cause pain in various locations, duodenal ulcers can sometimes present with right upper quadrant pain, especially if the ulcer is located high in the duodenum.
- Hepatitis: Viral or alcoholic hepatitis can cause right upper quadrant pain due to liver inflammation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Acute cholangitis: This is an infection of the bile duct, which can be life-threatening if not promptly treated. It often presents with the Charcot's triad of fever, jaundice, and right upper quadrant pain.
- Liver abscess: A collection of pus in the liver can cause right upper quadrant pain, fever, and other systemic symptoms. It requires urgent drainage and antibiotic treatment.
- Perforated viscus: Although less common, a perforation in the gastrointestinal tract (e.g., perforated peptic ulcer) can lead to peritonitis and severe abdominal pain, including in the right upper quadrant.
- Rare diagnoses
- Pancreatic cancer: While more commonly associated with mid-back pain, pancreatic cancer can sometimes present with right upper quadrant pain, especially if the tumor is located in the head of the pancreas.
- Right upper quadrant lymphoma: Lymphoma involving the liver, spleen, or lymph nodes in the right upper quadrant can cause pain in this area, though it is less common.
- Fitz-Hugh-Curtis syndrome: This is a rare condition where pelvic inflammatory disease causes inflammation of the liver capsule, leading to right upper quadrant pain, typically in young women but can occur in anyone with a history of pelvic infection.