American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Right rib fractures, specifically those involving the lower ribs (ribs 8-12), expose the liver to a significant risk of injury. The liver is located in the upper right quadrant of the abdomen, just beneath the diaphragm, and is particularly vulnerable in the context of trauma to the lower ribs.

Fractures in this area can cause direct laceration or contusion of the liver due to the close proximity of the organ to the rib cage. Additionally, as the ribs fracture and movement of the torso occurs—such as in breathing—there can be further movement of bony fragments that may additionally harm the liver.

While the gallbladder, stomach, and kidneys are also significant organs in the abdominal cavity, they are less likely to sustain direct injury from right rib fractures. The gallbladder is located more medially and inferiorly compared to the liver, making it less directly threatened. The stomach is on the left side of the abdomen, away from the impact of right-sided rib fractures, and the kidneys, located further posteriorly, are generally more secure from such types of trauma unless there is significant blunt abdominal injury. Thus, the liver stands out as the primary organ at risk with these types of rib injuries.