Right upper quadrant abdominal pain: Difference between revisions
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[[File:GallbladderAnatomy-en.svg|thumb|Gallbladder anatomy]] | [[File:GallbladderAnatomy-en.svg|thumb|Gallbladder anatomy]] | ||
===Workup=== | ===Workup=== | ||
*CBC | ====Labs==== | ||
* | *Abdominal panel | ||
* | **CBC | ||
* | **Chemistry | ||
* | **LFTs + lipase | ||
**Coagulation studies (PT, PTT, INR), as a marker of liver function | |||
*[[Urinalysis]] | *[[Urinalysis]] | ||
*Urine pregnancy ( | **Leukocytes will be present in 40% of patients<ref>Baird DLH, Simillis C, Kontovounisios C, Rasheed S, Tekkis PP. Acute appendicitis. BMJ. 2017;357:j1703. Published 2017 Apr 19. doi:10.1136/bmj.j1703</ref> | ||
**Urine pregnancy test (if age and sex appropriate) | |||
====Imaging==== | |||
*[[Biliary ultrasound]] | *[[Biliary ultrasound]] | ||
* | *Consider [[CXR]] to assess for free air under the diaphram | ||
** | **If at risk for [[perforated ulcer]] (e.g., age >55) | ||
* | *Consider [[ECG]] | ||
**If may be cardiac in nature | **If may be cardiac in nature | ||
Revision as of 22:20, 14 February 2024
Background
- This page outlines the general approach to RUQ pain
Classification by Abdominal pain location
| RUQ pain | Epigastric pain | LUQ pain |
| Flank pain | Diffuse abdominal pain | Flank pain |
| RLQ pain | Pelvic pain | LLQ pain |
Clinical Features
- Right upper quadrant pain
Differential Diagnosis
RUQ Pain
- Gallbladder disease
- Pancreatitis
- Acute hepatitis
- Pancreatitis
- GERD
- Appendicitis (retrocecal)
- Pyogenic liver abscess
- Bowel obstruction
- Cirrhosis
- Budd-Chiari syndrome
- GU
- Other
- Hepatomegaly due to CHF
- Peptic ulcer disease with or without perforation
- Pneumonia
- Herpes zoster
- Myocardial ischemia
- Pulmonary embolism
- Abdominal aortic aneurysm
Evaluation
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Workup
Labs
- Abdominal panel
- CBC
- Chemistry
- LFTs + lipase
- Coagulation studies (PT, PTT, INR), as a marker of liver function
- Urinalysis
- Leukocytes will be present in 40% of patients[1]
- Urine pregnancy test (if age and sex appropriate)
Imaging
- Biliary ultrasound
- Consider CXR to assess for free air under the diaphram
- If at risk for perforated ulcer (e.g., age >55)
- Consider ECG
- If may be cardiac in nature
Diagnosis
Management
- Treat underlying disease process
Disposition
- Disposition per underlying disease process
See Also
External Links
References
- ↑ Baird DLH, Simillis C, Kontovounisios C, Rasheed S, Tekkis PP. Acute appendicitis. BMJ. 2017;357:j1703. Published 2017 Apr 19. doi:10.1136/bmj.j1703