Differential Diagnosis for Gall Bladder Pain in the Absence of Gall Stones
- Single Most Likely Diagnosis
- Biliary dyskinesia: This condition is characterized by abnormal gallbladder motility, which can cause recurrent biliary-type pain in the absence of gallstones. It is a common cause of gallbladder pain without evidence of gallstones.
- Other Likely Diagnoses
- Chronic cholecystitis: Inflammation of the gallbladder can occur without the presence of gallstones, leading to chronic pain.
- Sphincter of Oddi dysfunction: This condition involves abnormal function of the sphincter that regulates bile flow, leading to biliary-type pain.
- Microlithiasis: The presence of small gallstones that are not visible on ultrasound can cause gallbladder pain.
- Do Not Miss Diagnoses
- Pancreatic cancer: Although rare, pancreatic cancer can cause obstructive jaundice and biliary-type pain, making it a critical diagnosis not to miss.
- Cholangiocarcinoma: Cancer of the bile ducts can also cause biliary obstruction and pain, emphasizing the importance of considering this diagnosis.
- Peptic ulcer disease: While not directly related to the gallbladder, peptic ulcers can cause referred pain to the right upper quadrant, mimicking gallbladder pain.
- Rare Diagnoses
- Porcelain gallbladder: A rare condition where the gallbladder wall becomes calcified, potentially causing chronic pain.
- Gallbladder polyps: Benign growths in the gallbladder can cause pain, although this is less common.
- Mirizzi syndrome: A rare condition where a gallstone becomes impacted in the cystic duct, causing obstruction and pain, although typically associated with gallstones, it can occur without.