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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Upper Abdominal Pain Worsening With Hiccups, Deep Breathing?

55 yr old female. I have been having pain in the upper right abdominal area under and below ribs also to the back - 4 days now. The pain is worse when I burp or hiccup (diaphragm spasms?). Deep breaths also are difficult. Pain sometimes radiates or refers to the collar bone area.
Tue, 9 Sep 2014
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General Surgeon,  's  Response
HI.
Thanks for a perfect book-picture type symptoms you have noted.
There is an inflammation of the Liver and / or under-surface of the diaphragm.
The most common cause of an abscess in the upper part of the liver.
Another causes are irritation on the diaphragm by abscess.
There is a possibility of a Cancer of the liver.
This is also causing the referred pain to the collar bone area, worsening on burping or hiccough.
I would advise the following:
Blood tests - routine, wbc for infection, blood sugar to rule out diabetes. Kidney functions, liver function to determine the damage to the liver.
Urine
Stool
Ultrasonography to start with and may be necessary as a guidance for biopsy and / or aspiration of the abscess / mass.
CT scan to confirm and to plan the treatment.
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What Causes Upper Abdominal Pain Worsening With Hiccups, Deep Breathing?

HI. Thanks for a perfect book-picture type symptoms you have noted. There is an inflammation of the Liver and / or under-surface of the diaphragm. The most common cause of an abscess in the upper part of the liver. Another causes are irritation on the diaphragm by abscess. There is a possibility of a Cancer of the liver. This is also causing the referred pain to the collar bone area, worsening on burping or hiccough. I would advise the following: Blood tests - routine, wbc for infection, blood sugar to rule out diabetes. Kidney functions, liver function to determine the damage to the liver. Urine Stool Ultrasonography to start with and may be necessary as a guidance for biopsy and / or aspiration of the abscess / mass. CT scan to confirm and to plan the treatment.