Amanda, right upper ?

1 Answer

Answer :

Amanda, right upper quadrant pain can be from a variety of problems, as there are lots of organs in that area. The most obvious, as you might expect, live in the abdominal cavity: liver, gallbladder, pancreas, stomach, intestines. Any of these organs can become inflamed from an infection, gallstone, etc. An ultrasound is a good initial test for the gallbladder and liver, but it typically does not visualize the pancreas very well due to the overlying gas in your intestines. Blood work can also reveal a lot of information-your doctor likely checked your basic chemistries and blood counts as well as liver tests and pancreas enzyme levels (amylase and lipase). Top considerations for "severe right upper quadrant pain" associated with nausea that is new and in a woman of your age would be acute cholecystitis or cholangitis (some sort of abnormality should be seen on an ultrasound and bloodwork), acute pancreatitis (can be detected by bloodwork and possibly seen on a CT scan, depending on the course and severity of the disease), acute hepatitis (although severe pain is not typically the main complaint), and stomach or small intestine ulcer. An intestinal infection or mechanical problem, such as a twist or obstruction, is possible as well but would usually involve more diffuse pain and lots of distension. Problems with the lung, diaphragm or muscle are also on the list. Finally, the possibility of a female problem, such as an ovarian cyst or even ectopic pregnancy, should always be considered in a young woman with abdominal pain. Seems that your doctor has initiated an evaluation that would be appropriate to look for most of the most common gastrointestinal causes of your symptoms. If everything turns up negative, I think a reasonable next step would be to consider an endoscopy or some sort of evaluation of your upper GI tract to evaluate for the presence of an ulcer. An abdominal CT scan may also reveal some additional information. It is reasonable to call your doctor first thing in the morning requesting test results and informing him or her that you are still in a lot of pain. Chills can be associated with severe pain or even a fever-if you feel you are getting worse, or if you have a fever, abdominal distension, loss of bowel movements, loss of passing gas, or intolerable pain, you should report to the emergency department for a more urgent evaluation.

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