Abdominal pain is common complaint in many emergency rooms. The nature and severity of the pain often varies according to the underlying condition causing the pain. Right upper quadrant (RUQ) abdominal pain, depending on the cause, may require medication or advanced surgical procedures to be relieved. The myriad of causes of RUQ pain means that its diagnosis sometimes presents a challenge to the attending physician. Some of these conditions are life-threatening and require prompt evaluation and treatment.
Gall Bladder Disease
The gall bladder stores bile made by the liver. Bile aids in the digestion process, specifically the digestion of fats. Some people (most commonly overweight middle-aged females) can develop stones in the gall bladder, and this can lead to a spectrum of conditions which all present with RUQ pain. This spectrum ranges from biliary colic which occurs when the muscles of the gallbladder spasm because the gallbladder outlet is blocked by a gallstone, to acute cholecystitis, which is inflammation of the gallbladder wall.
Liver Disease
Some diseases affecting the liver also present with RUQ pain. Hepatitis, regardless of the cause, may have RUQ pain as a symptom. Both benign and malignant tumors in the liver also sometimes present with RUQ pain. Advanced cirrhosis also has RUQ pain as part of constellation of symptoms. A liver abscess classically has RUQ pain as a symptom.
Pancreatic Disease
Though the pancreas is more centrally located in the upper abdomen, when it becomes inflamed (acute pancreatitis), it may cause pain in the RUQ as well as the central abdominal area.
Kidney Diseases and Other Causes
Kidney infections, stones and tumors more often than not cause right-sided back pain, but on occasion may cause RUQ abdominal pain as well.
Cancer of the ascending colon, peptic ulcer disease (especially perforated peptic ulcer) and some thoracic conditions can all cause RUQ pain. The thoracic conditions include pneumonia, pericarditis and even a heart attack (myocardial infarction).
References
- "Advanced Surgical Recall"; Blackbourne, L.; 2004
- "Bailey & Love Short Practice of Surgery"; Russel, R.C.G., et al.; 2009
