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Tenderness in the Right Upper Quadrant

CLINICAL DIAGNOSTIC MANUAL



Tenderness in the right upper quadrant is a symptom that may indicate various hepatic and biliary pathologies.


Condition

Description

Symptoms and Signs

Diagnostic Tests

Acute Cholecystitis

Acute inflammation of the gallbladder, commonly associated with biliary obstruction by stones.

Severe pain in the right upper quadrant, nausea, vomiting, fever, positive Murphy’s sign.

Abdominal ultrasound (assessment of gallbladder inflammation), blood tests (liver enzyme levels).

Acute Alcoholic Hepatitis

Acute liver inflammation due to excessive alcohol consumption.

Right upper quadrant pain, jaundice, fatigue, elevated liver transaminases.

Blood tests (assessment of liver function, enzyme levels, and hepatitis markers), history of alcohol use.

Acute Viral Hepatitis

Acute liver infection caused by viruses (hepatitis A, B, or C).

Right upper quadrant pain, jaundice, general malaise, elevated liver enzymes.

Specific serological tests for each type of hepatitis virus, blood tests (assessment of liver function).

Acute Hepatic Congestion

Acute accumulation of blood in the liver due to venous obstruction or heart failure.

Right upper quadrant pain, hepatomegaly, ascites, signs of heart failure.

Abdominal ultrasound (assessment of hepatic congestion), liver function tests, cardiac studies.


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