दाहिनी ऊपरी चतुर्थांश में दर्द

Where is my right upper quadrant?

The right upper quadrant is a section of your tummy (abdomen) on the upper right hand side.

Look down at your tummy, and mentally divide the area from the bottom of your ribs down to your pubic hair into four quarters. The quarter on your right side closest to your ribs is your RUQ.

© ब्लॉसन.कॉम स्टाफ द्वारा (2014)। "ब्लॉसन मेडिकल 2014 की मेडिकल गैलरी"। विकिजर्नल ऑफ मेडिसिन 1 (2)। DOI:10.15347/wjm/2014.010. ISSN 2002-4436

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उदर चतुर्थांश क्षेत्र

© ओपनस्टैक्स, CC BY 3.0, विकिमीडिया कॉमन्स के माध्यम से

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Which organs are in my right upper quadrant?

The organs within your right upper quadrant are your:

• जिगर।.

• पित्ताशय।.

• Duodenum and some other parts of your large and small bowel.

• Right kidney (at the back behind the other organs).

• अग्न्याशय का हिस्सा।.

• महाधमनी।.

There are also the skin and nerves of that area of your abdomen.

What causes right upper quadrant pain?

In adults, the most common causes of right upper quadrant pain are:

• पित्ताशय की पथरी।.

• शिंगल्स.

• Peptic ulcers - ulcers in the upper part of the guts.

• Gut problems (problems affecting the bowel).

• अग्नाशयशोथ।.

इन कारणों पर नीचे विस्तार से चर्चा की गई है।.

Gallstones and gallbladder problems

• पित्ताशय की पथरी can block the bile duct, causing biliary colic – a severe, crampy pain in the right upper abdomen, often worse after eating fatty meals.

• The pain may spread to the back and shoulders.

• An infection may develop, called पित्ताशय की सूजन, which causes more persistent RUQ pain along with a high temperature.

शिंगल्स

• शिंगल्स can cause pain in the right upper abdomen because it affects the nerves in that area.

• दर्द आमतौर पर शरीर के एक तरफ, पसलियों के नीचे या पीछे की ओर, एक पट्टी जैसी पैटर्न में होता है।.

• यह अक्सर जलन, तीखा, या झुनझुनी जैसा महसूस होता है, और त्वचा को छूने पर दर्द हो सकता है।.

• एक फफोलेदार दाने आमतौर पर कुछ दिनों बाद उसी क्षेत्र में दिखाई देते हैं।.

• Some people find they continue to get a pain long after the rash of shingles has gone. This is called postherpetic neuralgia.

• Many people get the shingles rash without significant pain.

यकृत की समस्याएं

The liver takes up a large part of your right upper quadrant but it doesn't often cause pain. Causes of pain from the liver include:

• हेपेटाइटिस (ए, B, और C). This will usually result in jaundice and a fever and feeling generally unwell in addition to some pain in that area. Pain is not necessarily a feature.

• फोड़ा. This is a collection of pus causing pain, tenderness and fever.

• Alcoholic liver disease. Too much alcohol can damage your liver, which may affect its function, turn your skin yellow (jaundice) and give you RUQ pain.

• यकृत कैंसर. This can start in the liver or have spread from other cancers. The liver may enlarge in certain blood cancers, such as lymphomas or ल्यूकेमिया, and this can cause discomfort.

आंत की समस्याएं

Several problems in your bowel can give you pain in the right upper quadrant. These include:

• डुओडेनल अल्सर. Pain usually starts a few hours after eating and may improve with एंटासिड. It can gradually worsen and, in severe cases, you may vomit blood. This is an emergency - it is important to go to hospital straight away.

• आंत्रशोथ. Infections in your gut tend to give you pain all over your abdomen, typically more in the middle but occasionally the pain may be in the RUQ area. It is usually associated with दस्त and/or being sick (vomiting). You may have a mild fever.

• अपच. This can give you a pain in the upper part of your abdomen, along with bloating and acid reflux.

• क्रोहन रोग और अल्सरेटिव कोलाइटिस. These long-term conditions can cause pain anywhere in the abdomen. They usually cause loose stools, sometimes with blood.

अग्न्याशय से आने वाला दर्द

The pancreas sits in the upper middle of the abdomen and helps digest food and control blood sugar. Pain in the pancreas can be caused by:

• अग्नाशयशोथ (सूजन). This can cause right upper quadrant pain, nausea, and vomiting. Pain may be felt in the middle or on the right. In तीव्र अग्नाशयशोथ there is usually also a fever and you often feel very unwell.

• अग्न्याशय का कैंसर. This can cause right upper quadrant pain or back pain but it often causes few symptoms until it is advanced.

महाधमनी से आने वाला दर्द

The aorta is the main blood vessel that carries blood from the heart through the abdomen to the rest of the body. Pain coming from the aorta can be caused by:

• महाधमनी धमनीविस्फार. The aorta becomes swollen and weakened and may cause abdominal or back pain if it starts to leak.

• महाधमनी विच्छेदन. The aorta can develop a tear in a weakened area of the lining of the aorta. This causes severe pain in the abdomen, back or chest.

• महाधमनी का फटना।. The aorta bursts, causing very severe pain in the abdomen, back or chest, and feeling very unwell.

कोई भी दर्द जो महाधमनी से आने का संदेह हो, एक चिकित्सा आपातकाल है और इसे तुरंत उपचार की आवश्यकता होती है।.

अन्य संभावित कारण क्या हैं?

As well as the more common causes already described, there are many other conditions which occasionally cause right upper quadrant pain.

• Irritation of the diaphragm. The diaphragm is a dome-shaped muscle at the bottom of the ribs. Pain can be caused by various conditions including a ruptured अस्थानिक गर्भावस्था, निमोनिया, or a hernia involving the diaphragm.

• Kidney stones and infections.

  • गुर्दे की पथरी can cause a severe pain - usually round the back - which occurs in spasms lasting from a few minutes to several hours.

  • एक गुर्दे की पथरी या संक्रमण can cause pain anywhere along your urinary tract. So this could be anywhere from your loin, around to the front, the right upper quadrant, or down to the lower part of your abdomen.

  • It may also be associated with a fever, pain when you wee, or passing urine more frequently.

• दिल का दौरा. This usually causes chest pain, but can sometimes cause pain in the right upper quadrant. You would usually feel very unwell, sweaty or short of breath.

• निमोनिया. This is an infection in the lung and normally gives you a खांसी, and a high temperature (fever), with or without breathlessness and pain in your chest. However, if the infection is in the lower part of your right lung, you may feel the pain in your right upper quadrant.

• फेफड़ों की झिल्ली में सूजन. Can also sometimes give you a pain low down in your chest and it can feel as though it is in your right upper quadrant..

• मधुमेही कीटोएसिडोसिस. का एक गंभीर जटिलता टाइप 1 मधुमेह that makes you very unwell generally, but abdominal pain can be one of the symptoms. This is an emergency and required immediate hospital admission.

• एडिसन की बीमारी. A complication of Addison's disease called an Addisonian crisis occasionally can give you abdominal pain. Again you would feel very unwell and this also is also a medical emergency.

• Pregnancy-related liver problems. Rare complications in pregnancy can cause right upper quadrant pain.

• Pelvic problems. Conditions such as श्रोणि सूजन रोग या अंडाशय की गांठें can sometimes cause pain that is felt higher up in the abdomen.

• बड-चियारी सिंड्रोम।. This is a rare condition where blood flow out of the liver is blocked.

These listed causes are not exhaustive, and many other conditions can occasionally cause pain in the right upper quadrant.

What causes right upper quadrant pain in pregnancy?

During pregnancy, all of the above conditions can occur but there are some specific pregnancy-related causes of pain in the right upper quadrant.

• अस्थानिक गर्भावस्था. This is where the pregnancy is developing outside of the womb, usually in one of the Fallopian tubes. It can cause right upper quadrant pain if it bleeds inside the abdomen, and this is a medical emergency.

• Pressure from the growing womb. The uterus can press on nearby organs and the diaphragm, causing discomfort.

• अपच. This is more common in pregnancy and can cause upper abdominal pain.

• मूत्र मार्ग संक्रमण (यूटीआई). Pain from UTIs can appear different during pregnancy because of the changes in positions of your organs due to the growing womb. They can occasionally cause pain in the right upper quadrant.

What causes right upper quadrant pain in children?

In young children it is often quite difficult for them to show exactly where the pain is. If this is the case, the range of options widens to almost any cause of abdominal pain.

In children common causes include:

• कब्ज. Hard or infrequent poos can cause right upper quadrant pain (or pain elsewhere in the abdomen).

• चिंता. Stress or worry can sometimes cause pain anywhere in the abdomen.

• मेसेंटेरिक एडेनाइटिस. Infection can inflame glands in the abdomen, causing pain, often after a cold.

• अपेंडिसाइटिस. Usually this gives pain in the lower right part of the abdomen but it can start around the belly button. Pain may be less clear if the child can’t describe it, or if the appendix has burst.

• निमोनिया. Infections of the lower parts of the lungs may cause pain in the right or left upper quadrant.

• आंत्रशोथ. This infection (usually viral) causes abdominal pain, vomiting, and diarrhoea.

When to see a doctor for right upper quadrant pain

If you have a pain which doesn't settle, you will probably need to see a health professional to help work out the cause.

How is right upper quadrant pain diagnosed?

A doctor will be able to get a reasonable idea of the cause for the pain by:

• Asking you some questions about where the pain is and what it feels like.

• Physically examining you by feeling your abdomen in the area you have the pain.

• Examining other parts of your body, if needed, such as the rest of your abdomen and your chest.

क्या परीक्षण आवश्यक हैं?

You may be asked to provide a sample of urine to check for blood, glucose (sugar) and other abnormalities. You may need further tests, depending on what the doctor thinks is causing the pain.

Possible tests might include:

• रक्त परीक्षण to check the function of your liver, and to look for signs of inflammation, infection, or other potential causes.

• एक अल्ट्रासाउंड स्कैन to look for common conditions such as gallstones.

• कभी-कभी एक छाती का एक्स-रे might be needed to rule out a problem in your lungs, such as infection.

Referral might be needed for:

• A look into your stomach and upper bowel with a camera (एंडोस्कोपी) and other scans and 'scopes'.

• ए एंडोस्कोपिक रेट्रोग्रेड कोलांजियोपैंक्रिएटोग्राफी (ईआरसीपी) to examine your gallbladder and pancreas.

• ए कम्प्यूटरीकृत टोमोग्राफी (सीटी) स्कैन, to look for abnormalities of the pancreas or kidneys.

It is very unlikely that you would need all these tests - tests will be chosen depending on the likely cause of the pain after the examination.

What if no cause is found after tests?

If a serious cause has been ruled out, this is reassuring, but the pain may continue in some cases.

Sometimes it is hard to find a cause - for example, bowel spasm in a condition like चिड़चिड़ा आंत्र सिंड्रोम may cause right upper quadrant pain and this can not be shown on tests.

It is also possible for there to be pain that is caused by "mistakes" in the signals your nerves are sending to your brain. This can cause "chronic" (ongoing) pain in various parts of your abdomen without any underlying medical cause.

Treatment for right upper quadrant pain

The treatment for RUQ pain depends on the cause. Treatments for a few of the common causes are briefly discussed below.

• पित्ताशय की पथरी. In some cases symptoms are not very troublesome and can be managed by sticking to a low-fat diet only. Many people choose to have their gallbladder removed, in an operation called a cholecystectomy. This can usually be done by keyhole (laparoscopic) surgery.

• पित्ताशय की सूजन is treated initially with एंटीबायोटिक्स, usually in hospital via injections or a drip (intravenous antibiotics). Once the infection has been treated, a cholecystectomy is usually advised.

• शिंगल्स. The pain and rash settle on their own in time, but some people may be advised to take an antiviral tablet to help reduce the risk of long-term nerve pain after shingles. Also, some people may need medication for a few weeks or months after the infection to manage their long-term pain.

• Kidney infections are treated with antibiotics. Mild infections can be treated with antibiotics at home. If you are very unwell you may need admission to hospital for intravenous antibiotics and fluids.

• गुर्दे की पथरी. Small kidney stones pass on their own eventually; you will need to drink plenty of fluids. Larger kidney stones may need one of a number of procedures done to break them up or remove them altogether.

• ए duodenal ulcer is usually treated with acid-suppressing medication, as is अपच.

दृष्टिकोण क्या है?

This depends on the cause of the pain. Your doctor should be able to give you an idea of the outlook once a diagnosis has become clear.