Final answer:
The severe abdominal and shoulder pain described by the obese 52-year-old woman suggests cholecystitis, likely caused by gallstones. Referred pain to the shoulder is common with this condition. Treatment focuses on pain management and treating the root cause.
Step-by-step explanation:
An obese 52-year-old woman who presents with severe pain in the right upper quadrant of her abdomen and pain in her right shoulder is most likely experiencing cholecystitis. Cholecystitis is the inflammation of the gallbladder, often due to gallstones blocking the bile duct, which can cause severe pain in the right upper quadrant and may refer to the right shoulder, a phenomenon known as referred pain.
Gallstones and associated cholecystitis are common in those with certain risk factors such as obesity and metabolic syndrome. Symptoms such as severe abdominal pain, nausea, vomiting, and potentially jaundice are indicative of cholecystitis. Treatment typically involves managing the pain and addressing the underlying cause, possibly with surgical removal of the gallbladder.