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A hard lump under the right side of the rib cage can indicate a serious disease. No one can diagnose your health issues without physically examining you, and this answer can't tell you with 100 percent certainty waht you have, either, but here are some possibilities for masses you can feel under your rib cage:

  • A tender, "squishy" mass at the bottom of the right side of your rib cage (in the upper right quadrant of your abdomen) can be an inflamed gallbladder. If cholecystitis (gallbladder inflammation) is the cause, it will hurt to press against the mass. 
  • A firm, irregular mass at the bottom of the right side of the rib cage (in the upper right quadrant of your abdomen) can indicate hepatomegaly, liver enlargement. This can be caused by any of a number of conditions: alcoholism, metastatic cancer (spreading to the liver rather than originating in the liver), congestive heart failure, glycogen storage disease, hepatitis A, hepatitis B, hepatitis C, fructose intolerance, mononucleosis, biliary cirrhosis, Reye syndrome, cholangitis (inflammation of the bile duct), or hepatic steatosis, also known as fatty liver. If you aren't having other symptoms, however, just having an irregularly shaped mass below your liver doesn't necessarily mean you have a dreadful or deadly disease.

  • Colon cancer can cause a mass just about anywhere in the abdomen.
  • Crohn's disease causes sausage-shaped masses just about anywhere in the abdomen. There are usually multiple masses.
  • Liver cancer usually causes a hard, lumpy mass at the bottom of the right side of the rib cage. However, you would not have just the mass as a symptom.

What about mesenteric ischemia? This condition causes pain, often intense pain, but it doesn't cause masses in the abdomen. The pain will be worse after eating. It can be intense if you get dehydrated and then drink a lot of ice water. The cold fluid in your stomach and small intestine will reduce circulation in your gut even more and cause even worse pain. There will typically be nausea, vomiting, diarrhea, and flatulence. Sometimes the diarrhea is "explosive."  The condition can be acute or chronic. Acute mesenteric ischemia usually occurs in younger, active people. Typically, the victim will be someone who is running a race on a hot day and stops to get rehydrated with ice water. Chronic mesenteric ischemia is usually due to atherosclerosis. Acute mesenteric ischemia is rapidly fatal in a majority of cases. Chronic mesenteric ischemia causes severe pain for years, but is generally survivable. Acute mesenteric ischemia may have to be treated with emergency surgery that even young, athletic people don't survive. Chronic mesenteric ischemia may be treated with statins and blood pressure medications.

Abdominal aortic aneurysm (commonly called AAA) doesn't cause any symptoms until they start to expand. An expanding aneurysm causes abdominal pain and lower back pain that just won't go away. If you have an AAA, you'll feel full after eating just a little food. You'll probably have nausea and indigestion. Sometimes interruptions in the normal flow of blood cause the toes to turn blue. If the aneurysm can be felt, it isn't a "hard" mass. It pulsates because it is conducting blood.

An AAA isn't something you want to ignore. Sixty-five percent of people who experience a ruptured AAA die before they can get to the hospital. When an AAA is about to "blow," there may be an episode of fainting or extreme fatigue from which the patient temporarily comes back. The skin turns "bluish," there can be altered mental status, and the heart beats unusually fast as it tries to get blood where it needs to go. That's the time to get to a hospital as soon as possible.

Should you stay away from the ER or hospital if you don't have insurance? In the United States, if you are having a medical emergency, the hospital is legally obligated to treat you. You may face a difficult financial situation after you get out, but if you have cancer, mesenteric ischemia, or an AAA, medical treatment could save your life.

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