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aukebay Question 4 - The correct answer is aukebay (b) - Back The clinical differential diagnosis of the right upper quadrant pain should include all of the listed possibilities, except viral hepatitis. The patient was known to have gallstones, which could be associated with acute cholecystitis, or with acute common duct obstruction due to passage of a stone. This latter usually causes epigastric pain, rather than right upper quadrant pain. Fatty liver of pregnancy also can cause aukebay right upper quadrant pain, although the onset is not usually sudden. Hepatic infarction causes pain if the capsule is involved and the exacerbation with movement suggests this diagnosis (pulmonary embolus also has to be considered).
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