What Can Be Mistaken for Liver? A Guide to Mimicking Conditions

October 1, 2025 •

5 min read

According to the American Liver Foundation, up to 50% of people with liver disease have no symptoms in the early stages, making its signs, when they do appear, easy to confuse with other conditions. This confusion highlights the challenge of identifying what can be mistaken for liver disease, particularly given the shared location and nature of many abdominal ailments.

Quick Summary

Many medical conditions, especially those involving the gallbladder, pancreas, kidneys, and lungs, can present with symptoms that mimic liver issues. These overlapping signs, including pain and jaundice, necessitate a thorough medical evaluation for an accurate diagnosis.

Key Points

Symptom Overlap: Many conditions, especially affecting the gallbladder, pancreas, and kidneys, can present with symptoms like abdominal pain and jaundice that mimic liver disease.
Location is Deceiving: The close proximity of organs in the upper right abdomen means pain from one, like the gallbladder, is often mistaken for liver pain.
Differentiating Pain: Liver pain is typically a dull, steady ache, whereas gallbladder pain is often sharp, sudden, and triggered by fatty meals. Pancreatic pain can be severe and radiate to the back.
Referred Pain: Pain from a problem organ, such as a gallbladder issue, can be felt in a different location like the right shoulder, further confusing the diagnosis.
Non-Specific Symptoms: Fatigue, nausea, and general abdominal discomfort are common to many conditions, including early liver disease, making them unreliable indicators on their own.
Professional Diagnosis: Due to the complexity, only a doctor using a combination of patient history, physical examination, blood tests, and imaging can accurately diagnose the source of the problem.

Why Liver Symptoms Are Often Confused

The liver, a crucial organ located in the upper right quadrant of the abdomen, shares this area with several other vital structures, including the gallbladder, pancreas, right kidney, and parts of the large and small intestines. This close proximity means that a problem in one organ can cause symptoms that are easily mistaken for an issue with another. Compounding this, many liver disease symptoms are non-specific, such as fatigue, nausea, and abdominal pain, making a precise diagnosis based on symptoms alone challenging. Furthermore, a phenomenon known as referred pain can cause discomfort from a specific organ to be felt in a different location, such as pain from a gallbladder issue being felt in the right shoulder. The following are some of the most common conditions that can be mistaken for liver disease.

Gallbladder Conditions

The gallbladder is a small, pear-shaped organ that stores bile and is located just beneath the liver. Problems with the gallbladder can cause pain that is frequently misidentified as liver pain.

Gallstones (Cholelithiasis)

Gallstones are hardened deposits of digestive fluid that can form in the gallbladder. When a gallstone blocks one of the bile ducts, it can cause a sharp, sudden, and intense pain known as biliary colic. This pain is located in the upper right abdomen and can radiate to the back or right shoulder blade, closely mimicking liver pain.

Cholecystitis

This condition is an inflammation of the gallbladder, often caused by a gallstone blocking a cystic duct. In addition to severe, steady pain in the upper right abdomen, cholecystitis can cause fever, nausea, vomiting, and jaundice, all of which are also symptoms of liver disease. In fact, severe gallbladder sepsis can cause abnormal liver function tests due to the stress on the system.

Pancreatic Diseases

The pancreas is a gland located behind the stomach. Inflammation of the pancreas, or pancreatitis, can cause symptoms that are often confused with liver problems, as the two organs are closely related in function.

Pancreatitis

Pancreatitis causes severe, sudden pain in the upper abdomen, which may radiate to the back. The pain from pancreatitis is often described as feeling worse after eating, especially fatty foods. This condition can also cause jaundice (yellowing of the skin and eyes) if the inflammation blocks the bile duct, a classic sign of liver disease. Other overlapping symptoms include nausea, vomiting, and fever.

Kidney and Urinary Issues

The kidneys are located on either side of the spine, with the right kidney situated near the liver. Problems with the right kidney can cause pain that may be confused with liver discomfort.

Kidney Stones (Nephrolithiasis)

Kidney stones cause intense, colicky pain in the flank or back, which can sometimes be referred to the front of the abdomen. This pain may be confused with liver or gallbladder pain, though it often involves the side more than the front. Symptoms also include blood in the urine, fever, and painful urination.

Hepatorenal Syndrome

This is a specific, life-threatening complication of severe liver disease, but it demonstrates how the two organs are interconnected. In this syndrome, the kidneys fail, leading to a buildup of toxins that can mimic worsening liver function. Though technically a complication of liver disease, a patient may initially present with kidney failure symptoms, such as reduced urination and swelling, while the underlying liver issue is still developing or being diagnosed.

Lung and Diaphragm Problems

Because the liver is situated just below the diaphragm, conditions affecting the right lung or the diaphragm itself can create pain that feels like it originates from the liver.

Right-Sided Pneumonia

An infection of the right lung can cause chest pain that may radiate to the upper abdomen, giving the impression of liver pain. This is often accompanied by fever, cough, and shortness of breath, which might be initially misinterpreted in a patient presenting with abdominal discomfort.

Hepatic Hydrothorax

This is a complication of advanced liver disease (cirrhosis) where fluid accumulates in the chest cavity, compressing the right lung. While it is a result of liver disease, its primary symptoms—shortness of breath and chest pain—are related to the lungs and can be mistaken for a standalone respiratory problem.

Other Digestive and Systemic Conditions

Peptic Ulcer Disease: Ulcers in the stomach or upper small intestine can cause a gnawing, burning pain in the epigastric (upper middle) area of the abdomen that sometimes radiates to the right upper quadrant.
Gastrointestinal (GI) issues: Conditions like gastritis (inflammation of the stomach lining) or simple indigestion can cause generalized upper abdominal pain and bloating that can be mistaken for a more serious liver issue.
Systemic Conditions: Autoimmune conditions or rare vascular disorders like polyarteritis nodosa can also cause severe abdominal pain that might be confused with liver disease.

Comparison Table: Distinguishing Symptoms


Symptom	Liver Issues (Hepatitis, Cirrhosis)	Gallbladder Issues (Gallstones, Cholecystitis)	Pancreatitis
Pain Location	Dull, steady, widespread ache in upper right abdomen, can radiate to shoulder.	Sharp, sudden, severe pain under right ribs; radiates to back or shoulder.	Severe pain in upper abdomen, can radiate to the back.
Pain Trigger	Not typically food-triggered, but can worsen with advanced illness.	Often triggered or worsened by eating fatty or heavy meals.	Can be triggered or worsened by alcohol or fatty meals.
Pain Duration	Persistent, chronic pain in advanced disease.	Episodic, lasting 30 minutes to several hours.	Acute episodes, often severe and long-lasting.
Associated Symptoms	Fatigue, weakness, jaundice, itchy skin, dark urine, pale stool.	Nausea, vomiting, fever, sometimes jaundice.	Nausea, vomiting, fever, swollen abdomen, jaundice.

Conclusion: The Importance of Accurate Diagnosis

Given the significant overlap in symptoms, relying solely on abdominal pain or other vague signs to self-diagnose a liver problem is dangerous. The differences in pain characteristics, triggers, and associated symptoms, while helpful, are not definitive and require expert medical interpretation. Prompt and accurate diagnosis is critical, as the treatment and prognosis for gallbladder inflammation, pancreatitis, or kidney issues differ dramatically from those for advanced liver disease like cirrhosis. A healthcare provider will use a combination of medical history, physical examination, laboratory tests (such as liver function tests, amylase, and lipase), and imaging studies (like ultrasound or CT scans) to pinpoint the actual source of the problem and ensure the right course of treatment is followed. For more information on liver health, visit the Cleveland Clinic.

Diagnostic Tools for Differentiation

Medical professionals use a range of tools and procedures to distinguish between these conditions:

Blood Tests: Liver function tests (LFTs) measure enzymes and bilirubin levels, while amylase and lipase levels are checked for pancreatic health.
Urinalysis: A simple test to check for kidney issues or infection.
Imaging Studies: Ultrasound is a common first step for examining the liver, gallbladder, and bile ducts. A CT scan may provide a broader view of the abdomen.
Patient History and Physical Exam: Detailed questions about the nature of the pain, its triggers, and location, along with palpating the abdomen, help guide the diagnostic process.

Frequently Asked Questions

Yes, gallbladder pain is very often mistaken for liver pain because the organs are located close together in the upper right abdomen. Gallbladder pain tends to be sharper and sudden, often triggered by fatty foods, while liver pain is typically a dull, widespread ache.

While symptoms like jaundice and abdominal pain can overlap, pancreatic issues often present with severe, upper abdominal pain that radiates to the back and worsens after eating. Liver pain is more of a dull, chronic ache.

Yes, problems with the right kidney, such as an infection or kidney stones, can cause pain in the flank that may be confused with liver pain. In severe liver disease, a complication called hepatorenal syndrome causes kidney failure, linking the two organ systems.

Many symptoms overlap, including fatigue, nausea, general abdominal pain, and weakness. Early liver disease often has no symptoms at all, making these non-specific signs particularly misleading.

Referred pain is when pain from an organ is felt in a different part of the body. For example, a gallbladder problem might cause pain in the right shoulder, potentially obscuring the true cause of the issue.

Yes, a condition like pneumonia in the right lung can cause chest pain that radiates to the upper abdomen, mimicking liver pain. Certain heart conditions can also cause referred abdominal pain.

Doctors use a combination of methods, including a detailed patient history, physical exam, blood tests (like liver function tests, amylase, lipase), and imaging studies (such as ultrasound or CT scans) to accurately diagnose the source of the problem.