Differential Diagnosis for Right Upper Quadrant Pain
- Single most likely diagnosis
- Cholecystitis: This is the most common cause of right upper quadrant pain, often associated with gallstones, and typically presents with acute onset of pain, fever, and leukocytosis.
- Other Likely diagnoses
- Biliary colic: Pain from gallstones that have not yet caused inflammation of the gallbladder, often recurring and triggered by fatty meals.
- Peptic ulcer disease: Ulcers in the stomach or duodenum can cause right upper quadrant pain, especially if the ulcer is located near the pylorus.
- Hepatitis: Inflammation of the liver, which can be viral, toxic, or autoimmune in nature, presenting with right upper quadrant pain, jaundice, and elevated liver enzymes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute cholangitis: Infection of the bile ducts, which can be life-threatening if not promptly treated with antibiotics and drainage.
- Liver abscess: A collection of pus in the liver, often due to bacterial infection, which requires drainage and antibiotic therapy.
- Perforated viscus: A hole in the wall of the stomach or intestine, leading to peritonitis, which is a surgical emergency.
- Rare diagnoses
- Fitz-Hugh-Curtis syndrome: A rare condition where the liver capsule is inflamed, often due to pelvic inflammatory disease, presenting with right upper quadrant pain.
- Hepatic artery aneurysm: A rare condition where the hepatic artery is dilated, which can rupture and cause severe bleeding.
- Right upper quadrant pain due to pneumonia or pulmonary embolism: Although less common, these conditions can refer pain to the right upper quadrant and should be considered in the differential diagnosis.