Which spinal levels correspond to referred pain from gallbladder and liver?

• A. L1-L2
• B. T7-T9
• C. C5-C7
• D. S1-S2

Answer: (B)

Visceral pain from the gallbladder and liver is felt in skin areas served by the same spinal segments due to convergence of visceral and somatic afferents in the spinal cord. The nerves supplying these organs enter the spinal cord around the mid-thoracic levels, so the brain interprets the pain as coming from those dermatomes on the chest wall and upper abdomen. For the gallbladder and liver, this mapping corresponds to the thoracic segments around T7 to T9, which align with the epigastric and right upper quadrant region. Sometimes diaphragmatic irritation can bring a referral to the right shoulder via the phrenic nerve, but the core spinal levels involved are T7–T9. Levels like L1–L2, S1–S2, or C5–C7 do not align with the upper abdominal organ innervation, so they’re less likely to produce this specific referred pain pattern.