Severe pain in the right upper quadrant points to a rare anomaly

A patient’s severe right upper quadrant pain points to a rare congenital anomaly

Miguel, a 33-year-old male, presents to his GP for a recommended follow-up review and further investigation after an ED presentation with right upper quadrant pain, suspected secondary to biliary colic.

The ED discharge states that, at presentation, Miguel had severe right upper quadrant pain radiating to the back, with no associated fever or vomiting.

In ED, his observations were within normal limits, he was not jaundiced but he had right upper quadrant tenderness with a positive Murphy’s sign but no