Upper-right abdominal pain can have various causes, ranging in severity from 'needs attention' to 'generally fatal'. Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.
Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms. In order to diagnose upper-right abdominal pain, we could:
|Possible Urgent Medical Need||28%||Unlikely|
|Subphrenic Abscess||4%||Ruled out|
|Gallbladder Disease||3%||Ruled out|
|Budd-Chiari Syndrome||3%||Ruled out|
|Liver Disease||1%||Ruled out|
UPPER-RIGHT abdomen: Do you experience discomfort or pain behind the right rib cage?
Possible responses:→ No / only after meals / don't know
→ Occasional mild discomfort
→ Frequent mild and/or occasional moderate pain
→ Frequent moderate and/or occasional severe pain
→ Frequent or constant severe pain
Cardiac pain may occasionally present as upper abdominal pain. An acute myocardial infarction can cause upper-right or epigastric discomfort that may be similar to that of a gallbladder attack. Congestive heart failure may stretch the liver capsule.
The pain is usually in the upper-right abdomen or above the stomach.
Biliary pain rapidly increases in intensity, then remains constant for 4 to 6 hours, occasionally radiating to the right shoulder blade area. In cases of acute gallbladder inflammation, the pain can last longer than 6 hours and be accompanied by tenderness and fever.
As well as abdominal pain, the liver and area below the right rib are tender to the touch.
Liver disease is usually only painful if it stretches the capsule of the liver. The pain is felt in the upper-right quadrant beneath your rib cage, usually as a dull ache, or the pain can be sharp and can sometimes be accompanied by back/shoulder pain.
The pain is on the side(s) of the affected lung(s).
The pain occurs on the affected side, in the chest, upper abdomen, and/or shoulder.