An 88-year-old woman presented to our primary care clinic with recurrent right upper quadrant abdominal pain. Her history was negative for nausea, fever, vomiting, chest pain, heartburn, back pain, or changes in bowel movement patterns. There was no association between the pain and her eating patterns. She described the pain as dull, and rated it as a 4 to 5 out of 10. A physical examination was unremarkable except for a minimally tender mass in the right upper quadrant that was detected during palpation of the abdomen. A Murphy’s test was negative. A comprehensive metabolic panel, complete blood count, lipase test, amylase test, abdominal ultrasound, and abdominal x-ray (FIGURE) were ordered.
Recurrent right upper quadrant abdominal pain
Pradeepa Vimalachandran, MD, MPH
Jayashree Paknikar, MD
Creighton University School of Medicine, Omaha, Neb
Richard P. Usatine, MD
University of Texas Health Science Center at San Antonio
The authors reported no potential conflict of interest relevant to this article.
A minimally tender mass was detected during palpation of the abdomen, but a Murphy’s test was negative. An abdominal x-ray revealed the cause of the patient’s pain.