What is a common misleading differential diagnosis for right upper quadrant pain?

• A. Chronic liver disease
• B. Ileitis
• C. Gallstones
• D. Splenic rupture

Answer: (C)

Gallstones are frequently considered a common misleading differential diagnosis for right upper quadrant pain because they can cause symptoms that mimic other more serious conditions. Although gallstones primarily present with biliary colic or acute cholecystitis, they can also lead to pain that radiates to the right upper quadrant, sometimes making it difficult to distinguish from conditions such as hepatic issues or digestive organ problems.

The pain caused by gallstones can be episodic, leading to misinterpretation of the underlying issue. Patients may report pain in the right upper quadrant during attacks which could easily be confused with liver disease or other gastrointestinal disorders. Additionally, the overlap of symptoms can lead clinicians to consider gallstones in the differential diagnosis when in fact the problem may be unrelated.

Chronic liver disease, ileitis, and splenic rupture present with more specific symptoms and clinical findings that help differentiate them from gallbladder-related pain. For example, chronic liver disease typically involves more systemic symptoms like jaundice or ascites, ileitis is focused more on abdominal cramping and diarrhea, and splenic rupture generally presents acutely with hypotension or signs of internal bleeding. Thus, while all these conditions need to be evaluated, gallstones often pose a unique challenge in clinical presentations that can mis