Marian, age 52, presents with severe right upper quadrant pain. What might you suspect?

In the case of Marian presenting with severe right upper quadrant pain, cholecystitis is a highly relevant suspect due to the location and nature of the pain. Cholecystitis is the inflammation of the gallbladder, which often occurs due to a blockage from gallstones. The right upper quadrant is where the gallbladder is located, making the symptoms consistent with this condition. Patients often report not only significant pain in this area but may also have associated symptoms such as nausea, vomiting, and sometimes fever or jaundice, depending on the severity and duration of the condition.

Other conditions listed, while they may cause abdominal pain, typically would not localize pain to the right upper quadrant in a manner consistent with cholecystitis. For instance, appendicitis generally presents with pain that starts in the periumbilical area and then moves to the right lower quadrant. Crohn's disease can lead to varied abdominal pain depending on the region affected but does not specifically target the right upper quadrant. Irritable bowel syndrome is characterized by changes in bowel habits and abdominal discomfort but lacks the acute, localized pain that strongly suggests a gallbladder issue.

Thus, given the specific symptoms presented along with the common clinical drama associated with ch