Abstract
This chapter focuses on various causes for the pain in right hypochondrium. Pain in the right hypochondrium may proceed from any of the following organs: (1) liver and gallbladder, (2) duodenum, (3) head of the pancreas, (4) right kidney, (5) appendix vermiform, (6) colon (7) uterine appendages, (8) intrathoracic disease, (9) affections of the spine or chest wall, and (10) subdiaphragmatic abscess in fascioliasis. The differential diagnosis is rendered difficult by the circumstance that disease may be simultaneously present in more than one of these situations. The pain of biliary colic may be felt chiefly in the right hypochondrium but tends to radiate through to the back and up toward the right shoulder. A duodenal ulcer may cause deep-seated pain in the right hypochondrium, usually with the character of hunger pain. The pain of renal colic may be difficult to distinguish from that of gallstone colic, lead colic, or appendicitis, but it begins below the lower ribs posteriorly and has a tendency to pass downward toward the umbilicus and thence into the groin. During or after the attack, there may be blood and gravel in the urine.
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