Which organ set is associated with diaphragmatic irritation?

Which organ set is associated with diaphragmatic irritation?

• A. Colon and rectum
• B. Liver, gallbladder, and duodenum
• C. Stomach and pancreas
• D. Spleen and stomach

Answer: (B)

Diaphragmatic irritation often presents as referred pain to the shoulder because the diaphragmatic pleura and peritoneum share sensory input with the phrenic nerve (C3–5). Organs directly contacting the undersurface of the diaphragm are most likely to trigger this referral pattern. The liver, gallbladder, and the duodenum lie beneath the right hemidiaphragm, so irritation from disease in these structures commonly manifests as right shoulder pain. The other organ groups are not consistently in contact with the diaphragmatic surface, so they don’t produce the classic diaphragmatic-referred shoulder pattern as reliably.

Diaphragmatic irritation often presents as referred pain to the shoulder because the diaphragmatic pleura and peritoneum share sensory input with the phrenic nerve (C3–5). Organs directly contacting the undersurface of the diaphragm are most likely to trigger this referral pattern. The liver, gallbladder, and the duodenum lie beneath the right hemidiaphragm, so irritation from disease in these structures commonly manifests as right shoulder pain. The other organ groups are not consistently in contact with the diaphragmatic surface, so they don’t produce the classic diaphragmatic-referred shoulder pattern as reliably.