Pain in the right hypochondrium during inspiration

Pain in the right upper quadrant with deep inspiration is a common symptom of various diseases. In this case, we must take into account not only the possible pathology on the part of the digestive organs localized under the diaphragm, but also the proximity of the lungs, pleura, mediastinum, intercostal muscles and nervous branches.

What changes occur in the hypochondrium in the act of breathing?

The diaphragm, serving as the upper border of the hypochondrium, is an active participant in the act of breathing. It, together with the thorax, provides respiratory movements. The goal is to create a negative pressure in the pleural cavity, so that the lung tissue is stretched as far as possible and air is inhaled.

The anatomical structures of the "sigh", apart from the diaphragm, include the external intercostal muscles. When the ribs contract, they go upward, the thorax increases in volume, especially in the lower parts. This is facilitated by an additional reduction in the diaphragm. On inhalation, it flattenes and descends toward the abdominal cavity.

In a state of rest and during exhalation, the dome moves towards the chest. People of different types of addition may have predominantly chest breathing( more typical for women, depends on the intercostal muscles) or abdominal breathing, when the main participant is the diaphragm.

Moving, she simultaneously pulls the organs of the abdominal cavity. The liver is "attached" to the inner part of the diaphragm by a powerful crescent ligament. Dense fibers of connective tissue are attached to the lower surface of the right lobe of the gallbladder. Sometimes there is a blind intestine with a vermiform appendage, loops of the small intestine.

In exhalation, the internal intercostal muscles and abdominal wall are actively engaged. They press down on the organs located in the upper floor of the peritoneum and the diaphragm in order to reduce the volume of the chest. Reducing simultaneously with the abdominal muscles, the diaphragm increases the pressure in the abdominal cavity.

The greater the resistance of the lung tissue( loss of elasticity in sclerosing, inflammation), the more strained muscles. Their work is greatly enhanced with increasing respiratory rate, with physical activity.

With forced breathing, the muscles of the neck, back and chest are connected to the process

Mechanism of pain in the hypochondrium with inspiration

Familiarity with the anatomical structures and their functional participation in the act of breathing will help us understand the causes of pain in the hypochondrium right on inspiration. By the mechanism of education, it is necessary to divide all the pains in the right hypochondrium into those caused by:

• by the digestive organs;
• by the organs of the thorax;
• by other anatomical formations that form irradiation.

Painful sensations in the area of ​​the liver of a piercing nature often disturb healthy untrained people if they have to run. In this situation, pain in the right hypochondrium is usually worried in the front.

Their appearance is explained by:

• spastic contractions of the diaphragm due to a malfunction of the rhythm of normal breathing;
• with an increased level of the adrenaline hormone, which increases the blood filling of the liver and the extension of the capsule, and also reduces the tone of the muscular layer of the gallbladder and ducts( overflow causes pain).

Pain in the right hypochondrium with strengthening with deep inspiration can be caused by inflammatory pathology of the liver, gallbladder due to local involvement in the process of the peritoneum.

This feature is used by doctors to diagnose the extent of inflammation when the patient is specifically asked to breathe deeply and draw his attention to the change in the nature of the pain. Consider specific diseases of the digestive system, accompanied by pain during breathing.

Causes of dull pain in the hypochondrium on the right with inspiration

Diseases of the digestive tract cause dull or acute pain depending on the phase and stage. In a chronic course with rare exacerbations, patients note inconsistent soreness in the lower thorax on the right side with a deep inspiration.

Chronic inflammatory processes in the liver, gall bladder are accompanied by partial sclerosis( replacement of one's own tissue with scars) parenchyma of the organ or wall of the cavity, deformation. This disrupts the location of the ligament apparatus. And when breathing and pulling up the diaphragm, it causes pain in the side or above the projection zone.

Chronic cholecystitis is a common disease of the gallbladder of inflammatory nature. Outside exacerbation gives pulling and dull pains in the hypochondrium on the right. In patients with a long "experience" of the disease, the bladder becomes thinner, becomes covered with scarring and adhesions. Painful sensations arise not only with a deep breath, but also with movements of the trunk, turns.

Dyskinesia of bile ducts is considered the initial stage of cholecystitis and cholangitis. It is expressed in violation of the contractile function of the bladder and ducts, the pains are either dull or spasmodic.

It is observed in nervous people, prone to irritability, experiences, disruption of the hormonal balance. The connection between pain and inhalation is caused by impaired breathing regulation, discoordination of contractions of muscle groups. Soothing treatments help to get rid of unpleasant symptoms.

Hepatitis - inflammatory liver disease contributes to swelling of the tissue and an increase in the volume of the body, the pain is caused by the expansion of the capsule.

Usually they are obtuse, patients mark "feeling of heaviness" on the right in the hypochondrium.

Breath enhancement is possible when trying to actively move, play sports in the phase of remission, joining cholecystitis. Fatty degeneration and cirrhosis of the liver are a long process with deformity of the organ, replacement with scar tissue, tension of the ligamentous apparatus of the diaphragm.

When there are sharp pains in the hypochondrium right on inspiration?

Sharp pain in the right hypochondrium with an increase in inspiration is typical for a clinical picture of an acute inflammatory process with local peritonitis. Acute cholecystitis - accompanied by a pronounced right-sided pain syndrome with irradiation in the scapula, waist, shoulder, collarbone.

At the same time, patients complain of nausea, vomiting, eructation of bitterness, significant fever, chills. When palpating the abdomen, severe soreness is detected at the point of the gallbladder, sometimes an enlarged and strained bubble. On the offer to breathe deeply, patients, on the contrary, hold their breath to the surface. In this way, it is possible to reduce the irritation of the peritoneum.

Gallstone disease is characterized by a cutting pain when the stone moves along the ducts. Irradiation is very pronounced in the right side of the chest, lower abdomen, back. At the height of the attack, vomiting of bile is observed. During the interictal period, the pain remains, but take a dull character.

From the gallbladder infection passes to the pancreas

Appendicitis in atypical localization reaches the surface of the liver and diaphragm. The high location of pain is characteristic of inflammation of the appendix in the process of a long gestation period.

Pain is not localized in the iliac region, as in the classical picture, but in the right hypochondrium, in the back, accompanied by vomiting, high fever, is increased by inhalation. It is almost impossible to distinguish from cholecystitis. It is recognized only during the operation.

Abscess and echinococcal cyst of the liver with pronounced suppuration and growth stretch the organ, exert pressure on the capsule, therefore cause constant pains of a pulsating nature( with abscessing).Movements and breathing stimulate the pain syndrome.

Malignant neoplasms in the hepatic tissue or metastases to it are accompanied at the initial stage by a feeling of heaviness, then go on to intense constant pain in the hypochondrium on the right with increased breathing.

To be ill in the right hypochondrium in a patient can with irradiation from neighboring organs during exacerbation of chronic pancreatitis, peptic ulcer. Appear:

• dagger or cutting pain with the main localization in the epigastrium, just above the navel;
• nausea and vomiting;
• diarrhea, with blood or covered with fatty film;
• tachycardia;
• dizziness;
• lowering blood pressure.

In addition to irradiation, respiratory pain may be accompanied by organ rupture, the initial phenomena of peritonitis. In perforation of the ulcerous hepatic part of the intestine caused by Crohn's disease, peritoneal manifestations should also be expected.

Pathology of chest organs

The cause of pain in the right side, the hypochondrium with a sharp increase in inspiration, can be chest diseases. These include pathology: respiratory organs, heart and vessels, bone skeleton and muscles.

Pneumonia( pneumonia) is a common, independent disease or complication of bronchitis, sepsis. It is caused by pathogenic bacteria and viruses, if the immunity of the patient falls. Pain during breathing, with spreading into the abdominal cavity, is observed with right-sided pleuropneumonia( croupous).

Symptoms include:

• sudden onset;
• high temperature;
• cough with purulent sputum discharge, possibly with blood;
• severe malaise;
• shortness of breath;
• pain in the side and hypochondrium during breathing;
• cyanosis of the lips.

Pleurisy is an accumulation of inflamed fluid in the right pleural cavity, is a complication of pneumonia, a sign of pulmonary tuberculosis. Irritation of the pleural sheets causes severe pain in the back in the area of ​​the lower ribs and in the hypochondrium with irradiation to the abdomen, inability to breathe deeply, shortness of breath, lagging of the right side of the chest in the act of breathing.

X-ray shows fluid in the pleural cavity on the right to accurately determine the cause of pleurisy. It is necessary to take a repeated picture after its removal.

Patients have a general severe condition, severe intoxication, chills, high temperature jumps. Pleurisy can be caused by an abscess of the lung, a cancerous tumor, suppurated bronchiectasis.

An extremely dangerous condition causes thromboembolism of the pulmonary artery trunk. If the thrombus enters the artery of a lower order, then the changes are limited to the picture of pneumonia with necrosis of a part of the tissues( infarction).When the large diameter of the branch is blocked, the patient appears:

• sudden suffocation;
• sharp pains in the chest and abdomen;Blueing of the upper half of the body;
• cough with plentiful sputum and hemoptysis;
• weakness and loss of consciousness.

Abdominal form of myocardial infarction - is more often associated with localization of ischemia in the zone of the posterior wall of the left ventricle. The pains of compressive, burning or pressing type arise suddenly, are localized in the epigastrium, irradiate into the abdomen, back, scapula, impede breathing.

On ECG there are signs of ischemia, blockade, arrhythmia. The disease is so known to surgeons that no experienced doctor will start surgery for cholecystitis until an ECG study is performed.

Congestive heart failure is a complication of severe heart diseases affecting the myocardium. Violation of the contractility of the ventricles leads to a delay in blood in the limbs, abdomen, lungs. The liver suffers from one of the first.

Overflow of the portal vein causes the liquid part of the blood to exit into the parenchyma, swelling and tension of the capsule. The diaphragm has to work with increased strain, which causes spasmodic contraction. Accordingly, the patient feels heaviness in the right hypochondrium and acute colic with painful breathing.

Right-sided pneumothorax - characterized by rupture of lung tissue, airflow into the pleural cavity with compression of the right lung. The patient has a sudden shock, because of severe pain, he can not breathe, pressure drops. The cause is trauma of the chest, fibrous-cavernous pulmonary tuberculosis, abscessed pneumonia.

The pattern of multiple bilateral ridge fractures is clinically accompanied by sharp pains during breathing and movements

Diseases of the musculoskeletal skeleton of the chest can cause severe pain along the lower ribs, especially with breathing and movements. These include:

• bruises and fractures of the right ribs;
• intercostal neuralgia;
• muscle myositis;
• herpes zoster;
• osteochondrosis of lumbar and thoracic parts;
• infringement of a herniated intervertebral disk.

When a patient is examined, the doctor discovers painful points along the muscles, nerve endings, a sharp increase in pain on chest compressions and breathing, neurological signs( impaired sensitivity, changes in the tone in the limbs).

Pathology of other organs

• Other diseases that can irradiate pain in the hypochondrium and intensify with inspiration can be noted:
• right kidney pyelonephritis, especially accompanied by inflammation of the paranephric fiber around the upper pole;
• nephrolithiasis;
• hydronephrosis;
• adrenal tumors with metastases in the spine;
• thrombosis of the hepatic and hollow veins.

Given the diverse nature of lesions that can cause pain in the right upper quadrant associated with breathing, you can not tolerate it for a long time. In the presence of acute and severe pain, you should call an ambulance. If the previously habitual symptom changed irradiation and character, then you should contact the clinic. Self-treatment can damage and complicate the course of the disease.