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abdominal pain (right hypochondrial)

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Differential diagnosis for patients presenting with right upper quadrant abdominal pain are:

  • biliary pain - constant, nonparoxysmal pain which rapidly increases in intensity then plateaus, lasts four to six hours, occasionally radiates to the right subscapular area
  • acute cholecystitis - longer lasting (more than six hours) biliary pain with tenderness, fever, and/or leukocytosis
  • dyspepsia - bloating, nausea, belching, intolerance to fatty foods
  • duodenal ulcer - pain two hours after meals, relieved by taking food or antacids
  • hepatic abscess - pain associated with fever and chills; palpable liver and subcostal tenderness
  • acute myocardial infarction - right upper quadrant or epigastrium discomfort; may be similar to biliary pain (1)

Other possible causes of right upper quadrant pain include:

  • duodenal ulcer
  • acute pancreatitis
  • pneumonia
  • subphrenic abscess