Right upper abdominal pain refers to discomfort felt in the upper-right area of the belly. It can arise from a variety of organs and systems, including the gallbladder and bile ducts, liver, stomach and intestines, pancreas, lungs (lower lobes), or the abdominal wall. Below you’ll find likely causes, symptoms that help narrow diagnosis, typical tests, and guidance on which specialists may be involved.
Frequent causes include gallstones, gallbladder inflammation (cholecystitis), bile duct obstruction, liver inflammation (hepatitis), and biliary colic. Peptic ulcer disease, some pancreatic conditions, and liver abscesses can also present with pain in this area. Less commonly, lower-lobe lung infections, rib or chest wall muscle strain, and nerve entrapment can mimic abdominal pain.
Associated signs give clues: fever and chills suggest infection or inflammation; jaundice (yellowing of the skin or eyes) points to liver or bile-duct problems; severe nausea or pain worsening after meals favors gallbladder or gastrointestinal causes. Shortness of breath or chest pain may indicate lung or cardiac evaluation is needed. No single symptom confirms a diagnosis—clinical assessment is required.
Evaluation usually begins with medical history and physical exam. Blood tests may include liver enzymes, bilirubin, inflammatory markers, and pancreatic enzymes when indicated. Abdominal ultrasound is often the first imaging test for right upper quadrant pain; CT or MRI can be used if ultrasound is inconclusive or to assess other structures. Endoscopic or specialized imaging may be required in some cases.
For initial assessment, primary care or internal medicine physicians can provide evaluation and referral. Gastroenterology or hepatology specialists handle gallbladder, bile duct, liver and many digestive causes; general surgery is involved if an operation may be needed. Infectious disease teams may be consulted for suspected liver infections. If pain is sudden and severe, accompanied by high fever, fainting, breathing difficulty, confusion, or marked jaundice, seek emergency services promptly.
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