Hidden pain in the liver area is usually referred to as pain in the right quarter of the ribs and is usually a sign of liver disease. Liver disease often doesn’t show symptoms until the condition has progressed to an advanced stage, so it’s vital to understand pain in the liver area. So, what are the common causes of pain in the liver area? 1, hepatitis: acute hepatitis pain in the liver is easy, because there is a layer of translucent “hepatic envelope” outside the liver, which is rich in sensory nerve endings. In the acute stage of hepatitis, the cells in the liver have different degrees of inflammatory swelling, the whole liver is also swollen with the swelling, so that all the envelope is taut, affecting the sensory nerve endings on the envelope, thus producing pain. If the pericardium and adjacent tissues are adhered, even if hepatitis becomes chronic or hepatomegaly is eliminated, when people are physically active, constipated, satiated, affecting diaphragmatic activity or other positional changes, it may still cause the pulling of the pericardium of the liver, which may produce tugging pain, tingling or hidden pain. 2.Fatty liver: In fatty liver, due to the enlargement of liver, the hepatic periosteum is overstretched, which stimulates the sensory nerves on the hepatic periosteum, which can cause pain in the liver area, and it can also be manifested as pressure pain and percussion pain, which is mostly seen in acute fatty liver. In rare cases of fatty liver, severe hepatic pain, accompanied by rebound pain, fever, increased peripheral blood leukocyte count, which resembles acute abdomen, may lead to surgical exploration. During the operation, the hepatic peritoneum is tense, the hepatic ligament is pulled, the hepatomegaly is grayish-yellow, and countless fat cysts are seen to rupture with inflammation under the microscope. 3.Cirrhosis: Many patients with mild cirrhosis have no symptoms, do not feel pain in the liver area, and behave healthily for many years. Symptomatic people show weakness, loss of appetite, nausea, emaciation, accompanied by liver enlargement some patients with cirrhosis may have liver pain, mostly hidden pain in the liver area. However, cirrhosis pain in liver area is relatively rare, and other causes should be carefully excluded. 4, liver abscess: refers to the liver parenchyma single or multiple pus accumulation, is bacteria, fungi or tissue amoeba protozoa and other microorganisms caused by liver suppurative lesions. When abscess occurs in the liver, the liver is mostly enlarged, and most of them have limited edema and obvious pressure pain in the intercostal space equivalent to the abscess. Some patients have persistent pain in liver area, which increases dramatically with deep breathing and body position movement. Hepatocellular carcinoma: Due to the rapid growth of tumor, the tension of hepatic peritoneum increases, or the infiltration of hepatic peritoneum by hepatocellular carcinoma leads to pain in liver area. It is often the first symptom of liver cancer in middle and late stages. Before liver pain, there may be discomfort in the right upper abdomen, and the pain is mostly located in the “right heart” or right quadrilateral ribs, which is mostly intermittent or persistent dull or stabbing pain. The pain in liver area is characterized by mild or severe pain, which can be relieved or even disappeared by itself for a period of time occasionally. Pain in liver area of liver cancer is more obvious at night or when one is tired.