Evaluating the Patient with Right Upper Quadrant Abdominal Pain

Jennifer Avegno; Matthew Carlisle

doi:10.1016/j.emc.2015.12.011

Evaluating the Patient with Right Upper Quadrant Abdominal Pain

Emerg Med Clin North Am. 2016 May;34(2):211-28. doi: 10.1016/j.emc.2015.12.011.

Authors

Jennifer Avegno¹, Matthew Carlisle²

Affiliations

¹ Section of Emergency Medicine, University Medical Center, Louisiana State University Health Sciences Center, 2000 Canal Street, Room 2720, New Orleans, LA 70112, USA. Electronic address: Javegn@lsuhsc.edu.
² Section of Emergency Medicine, University Medical Center, Louisiana State University Health Sciences Center, 2000 Canal Street, Room 2720, New Orleans, LA 70112, USA.

PMID: 27133241
DOI: 10.1016/j.emc.2015.12.011

Abstract

Right upper quadrant (RUQ) pain is among the most common complaints in the emergency department. The differential diagnosis is broad and includes gastrointestinal (GI) and non-GI causes for pain. Evaluation of patients requires a combination of history, physical examination, laboratory testing, and diagnostic imaging. This article details the anatomy and physiology of the right upper abdomen and approach to the history and physical examination of the most common diseases encountered in the emergency department. "Can't miss," non-GI diagnoses are discussed. Best practices of laboratory and imaging, and treatment of most common diagnoses of RUQ pain are reviewed.

Keywords: Abdominal pain; Cholecystitis; Cholelithiasis; Diagnostic testing; Hepatitis; Pancreatitis; Physical examination; Treatment.

Publication types

Review

MeSH terms

Abdomen / anatomy & histology
Abdominal Pain / diagnosis*
Abdominal Pain / diagnostic imaging
Abdominal Pain / etiology*
Biliary Tract Diseases / diagnosis
Diagnosis, Differential
Emergency Service, Hospital
Evidence-Based Medicine
Gastrointestinal Diseases / diagnosis
Humans
Liver Diseases / diagnosis
Pancreatic Diseases / diagnosis
Physical Examination / methods