Naito Yumi, Takagi Soshi, Inoue Keita, Sano Chiaki, Ohta Ryuichi
Communiy Care, Unnan City Hospital, Unnan, JPN.
Family Medicine, Shimane University Medical School, Izumo, JPN.
Cureus. 2023 Jan 24;15(1):e34174. doi: 10.7759/cureus.34174. eCollection 2023 Jan.
Right upper quadrant pain can originate from the liver, cholecystic duct, gallbladder, pancreas, or surrounding organs. Peritonitis in the right upper quadrant of the abdomen can be caused by lesions in these organs as well as the adjacent organs, such as the kidney and colon. The kidneys are surrounded by Gerota's fascia and fat; therefore, mild local inflammation may not cause peritonitis. Herein, we report the case of a 72-year-old woman with right-sided abdominal pain who was diagnosed with urinary extravasation due to a ureteral stone. Urinary extravasations can present with peritonitis. For effective diagnosis, prompt physical examination and abdominal ultrasound are essential, with the extent of extravasation being key to effective management. Therefore, general physicians should consider urinary extravasation, which is typically caused by kidney and urinary stones, in patients with right upper quadrant pain.
右上腹疼痛可源于肝脏、胆囊管、胆囊、胰腺或周围器官。腹部右上象限的腹膜炎可由这些器官以及相邻器官(如肾脏和结肠)的病变引起。肾脏被肾周筋膜和脂肪包裹;因此,轻度局部炎症可能不会引起腹膜炎。在此,我们报告一例72岁右侧腹痛女性患者,其因输尿管结石被诊断为尿外渗。尿外渗可表现为腹膜炎。为了进行有效诊断,及时的体格检查和腹部超声检查至关重要,外渗范围是有效治疗的关键。因此,普通内科医生对于右上腹疼痛的患者应考虑尿外渗,其通常由肾结石和输尿管结石引起。