What is the likely diagnosis for a patient experiencing right upper quadrant pain that worsens after eating?

• A. Acute cholecystitis
• B. Pancreatitis
• C. Appendicitis
• D. Peptic ulcer disease

Answer: (A)

The likely diagnosis of acute cholecystitis is suggested by the location of the pain in the right upper quadrant and its exacerbation following meals. Acute cholecystitis typically occurs when the gallbladder becomes inflamed, often due to a blockage caused by gallstones. Following a meal, especially one high in fat, the gallbladder contracts to aid in digestion, which can lead to increased pain if it is already inflamed. This patient presentation of right upper quadrant pain worsening after eating aligns well with the classic symptoms of acute cholecystitis.

The other conditions listed have different clinical characteristics. Pancreatitis usually presents with central abdominal pain that may radiate to the back and is not specifically related to meal consumption in the same way. Appendicitis would more commonly present with pain that starts around the umbilicus and then shifts to the right lower quadrant, rather than the right upper quadrant. Peptic ulcer disease may present with similar discomfort, but it is often associated with a burning sensation and may improve with eating or the use of antacids, which is not consistent with this patient’s symptoms.