Differential Diagnosis of Upper right quadrant pain in Abdomen

 causes Of upper right quadrant pain in Abdomen

 

gall stone colic

without  acute inflammation or infection

 jaundice , biliary colic , pian  in epigastrium & upper right quadrant

pain radiating to right lower scapula

no fever

 In the RUQ tenderness

WCC normal

confirmed by US scan

 

 Acute Cholecystitis

characterized by fever , guarding , +ve Murphy sign  , Leucocytosis

confirmed by U.S scam

 

Acute Pancreatitis

pain radiating direct through the back , pain better during sitting , or leaning forward

general abdominal tenderness , reduced bowel sounds

confirmed by increased serum amylase , lipase and C.T pancreas

Serum Lipase is very significant

in C.T Pancreas is oedematous

Acute Cholangitis

Fever , right upper quadrant abdominal pain , Jaundice or Charcot triad

Hypotension due to septic shock

CBC : LeukocytosiS

diagnosed by US scan , Blood Culture

Gastric Carcinoma

Old Male , Alchol

Anorexia , loss of weight ,  Fullness , Pain ( Troisier sign )  virchow node large lymph node in the left supraclavicular fossa

to be confirmed by Upper gastrointestinal endoscopy with Biopsy

Gastritis

Epigastric pain , dull or burning discomfort especially with sleeping

confirmed oesophogogastroscopy , barium meal and PH study

Esophagitis

retrosternal pain , heartburn

diagnosed by esophagpgastroscopy

Hiatus  Hernia

Heartburn  worsens with stoooping or lying

relieved by antacids

confirmed by esophagogastroscopy , barium meal

Acute Cronary Syndrome