Differential Diagnosis for Right Upper Quadrant Pain and Fever
- Single most likely diagnosis
- Cholecystitis: This is the most likely diagnosis due to the combination of right upper quadrant pain and fever, which are classic symptoms of inflammation of the gallbladder, often caused by gallstones.
- Other Likely diagnoses
- Cholangitis: Infection of the bile ducts, which can cause similar symptoms to cholecystitis, including right upper quadrant pain and fever.
- Pyelonephritis: Infection of the kidney, which can cause flank pain that may radiate to the right upper quadrant, accompanied by fever.
- Hepatitis: Inflammation of the liver, which can cause right upper quadrant pain and fever, although it is often accompanied by other symptoms such as jaundice.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Appendicitis: Although appendicitis typically presents with lower right quadrant pain, it can occasionally present with right upper quadrant pain, especially if the appendix is located in a retrocecal position. Missing this diagnosis can lead to perforation and severe complications.
- Perforated viscus: A hole in the wall of the intestine, which can cause severe abdominal pain, fever, and potentially life-threatening peritonitis if not promptly treated.
- Liver abscess: A collection of pus in the liver, which can cause right upper quadrant pain, fever, and potentially life-threatening complications if not treated.
- Rare diagnoses
- Fitz-Hugh-Curtis syndrome: A rare condition caused by pelvic inflammatory disease spreading to the liver, resulting in right upper quadrant pain and fever.
- Hepatic artery aneurysm: A rare condition where an aneurysm forms in the hepatic artery, which can cause right upper quadrant pain and potentially life-threatening bleeding if it ruptures.
- Echinococcal cyst: A rare parasitic infection that can cause cysts to form in the liver, resulting in right upper quadrant pain and fever.