Ultrasound assessment of right upper quadrant abdominal pain : part 1

Abstract

Right Upper Quadrant (RUQ) abdominal pain is one of the most common presenting complaints to any clinic or emergency department. Acute cholecystitis is the most frequent cause, however more than a third of cases are due to other conditions. Due to the numerous possible aetiologies of RUQ abdominal pain, a rapid test for identifying the cause and guiding further detailed investigation is required. Abdominal ultrasound (US) is the imaging modality of choice as a first investigation; it is readily available, rapid, cost-effective, and safe since it involves no ionising radiation or potentially nephrotoxic intravenous contrast agent. Abdominal US also assesses multiple upper abdominal organ systems that could be the source of the patient’s pain. It readily distinguishes other causes of pain including hepatic, pancreatic, adrenal, renal, vascular, intestinal and thoracic causes. Biliary and hepatic causes of RUQ pain will be discussed in this article. Discussion of other causes will appear in a follow-up article.