The liver and gallbladder occupy the right upper abdomen. Infections, trauma, tumors and other conditions that adversely affect the liver or gallbladder frequently provoke right upper abdominal pain. The onset of pain may be gradual or abrupt, depending on the underlying cause. Accompanying signs and symptoms and diagnostic tests help doctors pinpoint the cause of and appropriate treatment for upper abdominal pain.
Biliary Colic
Biliary colic refers to intense pain in the right upper abdomen caused by gallstones. Approximately one-third of people with gallstones experience episodes of biliary colic, reports Penn State College of Medicine's Milton S. Hershey Medical Center. Excessive cholesterol in the bile is the most frequent cause of gallstones, which affect women more frequently than men. Risk factors for the development of gallstones include obesity, excessive dietary cholesterol and diabetes. Gallstones tend to run in families, reports the National Institute of Diabetes and Digestive and Kidney Diseases.
Cholangitis
Gallstone blockage of the common bile duct, which transports bile from the gallbladder to the small bowel, often leads to an infection of the duct, or cholangitis. Symptoms of cholangitis include persistent right upper abdominal pain, fever, chills, nausea, vomiting, pale stools and jaundice, reports the online medical encyclopedia MedlinePlus. Early treatment is important to prevent serious complications such as gallbladder rupture or gangrene.
Liver Trauma
Traumatic injury of the liver typically causes right upper abdominal pain. In an April 2010 article published in the "International Journal of Collaborative Research on Internal Medicine & Public Health," Drs. Moosa Zargar and Marjan Laal report that the liver is the second most frequently injured organ in people sustaining abdominal trauma. Motor vehicle accidents, falls and gunshot and stab wounds remain common causes of liver injury. The severity of liver injuries varies from liver bruising, or hepatic hematoma, to breakage of the liver with high-volume internal bleeding. Severe liver injuries associated with brisk bleeding typically require emergency surgical repair. Mild to moderate liver injuries often stop bleeding without surgery.
Budd-Chiari Syndrome
Obstruction of the veins that carry blood from the liver is known as Budd-Chiari syndrome. A blood clot in the hepatic vein is the most frequent cause of Budd-Chiari syndrome, reports the Merck Manual for Healthcare Professionals. Outflow obstruction causes a backup of blood within the liver, which leads to liver swelling and right upper abdominal pain. Other symptoms may include nausea, vomiting, fatigue and jaundice. Long-standing obstruction of the blood outflow tract of the liver can lead to cirrhosis.
Blood clots in the hepatic veins may arise with a variety of conditions, including inherited disorders of the blood clotting system; increased red blood cells, or polycythemia vera; Crohn's disease; ulcerative colitis; abdominal trauma; and certain types of tumors. The development of Budd-Chiari syndrome is also an uncommon complication of pregnancy.
References
- Penn State College of Medicine Milton S. Hershey Medical Center: Biliary Colic
- National Institute of Diabetes and Digestive and Kidney Diseases: Gallstones
- MedlinePlus: Cholangitis
- "International Journal of Collaborative Research on Internal Medicine & Public Health"; Liver Trauma: Operative and Non-operative Management; Moosa Zargar, M.D., Marjan Laal, M.D.; April 2010
- Merck Manual for Healthcare Professionals: Hepatic Vein Disorders, Budd-Chiari Syndrome
