Differential Diagnosis for Upper Abdominal Pain
The patient's upper abdominal pain can be caused by various conditions. Here's a categorized differential diagnosis:
Single most likely diagnosis
- B. Distension of the liver capsule: This is often due to conditions like hepatitis or congestive heart failure, which can cause liver swelling and capsule distension, leading to pain.
Other Likely diagnoses
- A. Cystic duct obstruction: This condition, often related to gallstones, can cause biliary colic, which presents as upper abdominal pain, usually in the right upper quadrant.
- C. Fatty infiltration of the liver: While not typically painful, severe fatty liver disease can cause discomfort or pain in the upper abdomen due to liver enlargement.
- D. Pancreatic inflammation: Pancreatitis, whether acute or chronic, can cause significant upper abdominal pain, often radiating to the back.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- E. Peptic ulcer perforation: Although less common, a perforated peptic ulcer is a surgical emergency that presents with sudden, severe upper abdominal pain and can be fatal if not promptly treated.
- F. Rupture of a hepatic adenoma: This rare event can cause severe, acute abdominal pain and hemodynamic instability due to internal bleeding, requiring immediate intervention.
Rare diagnoses
- Other rare conditions such as liver abscesses, hepatic artery aneurysm rupture, or Budd-Chiari syndrome could also present with upper abdominal pain but are less common and would typically be considered after more frequent causes have been ruled out.