Overview of pain in the hepatic region
Liver pain is a pain that occurs in the right quadrant of the ribcage, most commonly seen in abdominal diseases, is a common cause of gastroenterology or general surgery, pain in the liver area of a number of diseases, there are differences in the manifestation of the majority of serious illnesses, once the pain in the liver area should be given enough attention, timely medical care.
Causes
Tumor, such as hepatocellular carcinoma; viral infection, such as chronic hepatitis B; gallstone obstruction or ingestion in the gallbladder, such as acute cholecystitis, chronic cholecystitis, cholelithiasis; bacterial infection, such as liver abscess, liver tuberculosis and so on.
Examination
1. Physical examination: pain on percussion of liver area.
2. Liver function tests
3. Imaging examination: chest X-ray, liver ultrasound, CT or MRI and other auxiliary examinations can clarify the diagnosis.
Differential diagnosis
1. Hepatocellular carcinoma Early hepatocellular carcinoma symptoms are not specific, while symptoms of middle and late hepatocellular carcinoma are more frequent. Common clinical manifestations include pain in liver area, abdominal distension, poor appetite, fatigue, emaciation, progressive hepatomegaly or epigastric mass, etc. Some patients have low fever, jaundice, diarrhea and upper gastrointestinal bleeding. Signs such as liver enlargement, jaundice and ascites are usually seen in middle and late stage hepatocellular carcinoma. In addition, patients with cirrhosis often have liver palms, spider nevus, enlarged male breast and lower limb edema. 2. Chronic Hepatitis B Patients often feel weak and easily fatigued, which may be accompanied by mild fever. Loss of appetite, nausea, anorexia, epigastric discomfort, abdominal distension and other gastrointestinal manifestations. Some patients may have discomfort, vague pain, pressure or percussion pain in the right upper abdomen and right quarter of the ribs. When the disease is more serious, there can be jaundice, but also see the liver and spleen, liver palms, spider nevus. 3. Cholecystitis (1) Acute cholecystitis: The pain often comes on suddenly, with severe pain, colic or persistent distension in the right upper abdomen; the pain may be radiating, and the most common radiating areas are the right shoulder and the lower angle of the right scapula, etc. The pain may be accompanied by nausea, vomiting, chills, and aversion to cold. It is accompanied by nausea, vomiting, chills, fever and jaundice. Abdominal examination reveals abdominal muscle tension, pressure, rebound pain and positive Murphy’s sign in the right upper abdomen and middle epigastrium.
(2) Chronic cholecystitis: persistent dull pain or discomfort in the right upper abdomen, dyspeptic symptoms such as nausea, belching, acid reflux, abdominal distension and burning in the stomach, pain in the right lower scapular region, and worsening of the symptoms after eating high-fat or greasy food. The course of the disease is long, and the disease is characterized by alternating acute attacks and remissions, and sometimes there are no symptoms during the remission period. There may be mild pressure and percussion pain in the gallbladder area, but no rebound pain, and the distended gallbladder may be seen in cholestasis cases.
Treatment principle
Treat the primary disease causing the pain in the liver area.