Is pain under the right hypochondrium a sign of liver cancer? Don’t necessarily pay attention to these

Pain in the liver area is like a demon to many patients with liver disease, and it brings bad luck. Many patients with liver disease believe that pain in the liver area is a manifestation of liver cancer, but is pain under the right hypochondrium a sign of liver cancer?

Not all pain in the liver area is caused by liver disease or liver cancer. When a patient has pain in the liver area, the doctor generally considers the following diseases in order, starting from the most common to the least common diseases.

1. Biliary tract disease: the most common

Including cholelithiasis, cholecystitis, etc. Because 80% of chronic liver disease patients have biliary tract diseases, liver pain is the most common.

And because of its anatomical location close to the liver, there is often "liver pain". The pain of more obvious cholecystitis is often fixed and localized, presenting as dull pain or colic attacks, and can often be diagnosed by B-ultrasound, that is, B-ultrasound indicates cholecystitis, but mild cholecystitis only has mild symptoms and a little discomfort, which is not easy to detect by B-ultrasound; but there are also many cases where B-ultrasound indicates cholecystitis without clinical symptoms.

2. Gastritis: common

Patients with chronic liver disease often have gastritis, accounting for about 70% of the total proportion. Sometimes it is also reflected in the liver area or right hypochondrium discomfort. In addition to the feeling of pain, it is often accompanied by bloating and warmth.

3. Diseases of the right lower thoracic costal margin: common

It is more common in costochondritis. This type of disease has obvious tenderness points locally, typically with rib cartilage protrusions. The pain worsens when coughing or taking a deep breath. If it is not neglected during the physical examination, it should not be missed. Of course, liver function and liver B-ultrasound are normal.

4. Strain of the right upper rectus abdominis: common

It is common in drivers and desk workers because the right upper part of the rectus abdominis is in a state of contraction and fatigue. Its physical signs are surface tenderness, which is more obvious when bending over, which is completely different from visceral pain.

5. Right diaphragmatic pleural lesions: rare

Patients with cirrhosis and ascites often have pleurisy, which is usually tuberculous or non-tuberculous inflammatory adhesions.

The patient can express it in the medical history, chest X-ray can show signs of lesions, and liver function tests and liver B-ultrasound examinations are normal. The "pain in the liver area" caused by this adhesion is mostly dull pain or dull pain.

6. Hepatocellular carcinoma: rare

Since early hepatocellular carcinoma is located in the liver, it does not have any clinical symptoms and will not induce pain in the liver area.

Only in the middle and late stages of liver cancer, due to its large size, will pain occur after it touches the liver capsule. If the tumor is located close to the liver capsule, when the tumor is small, the pain in the liver area is usually mild or non-existent. As the tumor grows, the pain in the liver area becomes more and more severe, and in the later stages, the pain is often unbearable and lasts for a long time. B-ultrasound can easily identify it.

Color Doppler ultrasound is the simplest method for differential diagnosis of liver pain, which is helpful for distinguishing cholecystitis, gallstones, hemangioma, etc., and is also good for diagnosing liver cancer. Liver function, alpha-fetoprotein, and carcinoembryonic antigen tests are cheap and effective, and are also helpful for distinguishing whether tumors and hepatitis occur.