Sonographic Evaluation of Causes of Right Hypochondriac Pain

Abstract

Background: Right hypochondriac pain or right upper abdominal quadrant (RUQ) pain is the most common type of pain, reason of 7.9% patients presenting at the OPD and ET departments of hospitals. RUQ main has multiple recorded causes with different frequencies of presentation. Ultrasound is the essential imaging methodology of decision for introductory evaluation and fills in as a practical and dynamic methodology to give a conclusive finding. Various systems of organs are incorporated at standard RUQ US, and an assortment of ultrasonographically diagnosable infection cycles can be recognized, including states of hepatic, pancreatic, adrenal, renal, gastrointestinal, vascular, and thoracic, all of which may bring about RUQ torment and pain. Most common causes, however, incorporate acute hepatitis and issues with gall bladder such as cholelithiasis as reported in existing literature The present study was thus conducted to evaluate the causes of right hypochondriac pain adopting ultrasound as the modality of choice. All the patients were scanned using SIMENS Grey scale/doppler ultrasound machine. Scanning was done in both transverse, longitudinal and any other plane deemed necessary to adequately visualize the right upper quadrant. Patients of either sex suffering from right hypochondrium pain were included in the study. They were referred from surgical OPD/ward of Chaudhary Muhammad Akram Teaching and Research Hospital. Duration of study was 4 months, during this period 154 patients were selected on the basis of  age, gender and  radiological findings,  informed, verbal consent was taken and ultrasonographic reports were collected  from radiologist office. It was found that out of 154 recorded cases, 93 were females and 61 males. Patients presented with a mixed frequencies of pain, highest being generalized abdominal pain. For the causes of RUQ pain, hepatic cyst was found to be the major cause present in 38.3% study participants followed by cholelithiasis (13.6%), hepatic hemangioma (10.4%), and right renal cyst (6.5%). Other findings included conditions like fatty liver (5.8%), gallbladder polyp (5.8%), right renal stones and hepatocellular carcinoma (3.9%). It was concluded that hepatic cysts and gall bladder stones are the major cause of RUQ pain in the present study sample. Although in some cases  non-significant causes included hepatic calcification, focal nodular hyperplasia and lipomas are causes pain. As in our cases, US seems to be an important diagnostic modelity in both the diagnosis and follow-up of Right hypochondriac pain and it may provide a faster, easier method of diagnosis.

Keywords: Right Hypochondriac Region, Cholelithiasis, Acute Hepatitis, Ultrasound, Inflammation.

DOI: 10.7176/JHMN/91-06

Publication date:July 31^st 2021