Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Key clinical features suggesting acute cholecystitis in a patient presenting with abdominal pain include:
- Right upper quadrant abdominal pain, often severe and persistent rather than colicky.
- Tenderness in the right upper quadrant on abdominal examination.
- Fever and signs of systemic inflammation such as tachycardia.
- Raised inflammatory markers including elevated white blood cell count and C-reactive protein.
- Possible nausea and vomiting accompanying the pain.
- Positive Murphy’s sign (pain on palpation of the gallbladder during inspiration) is often noted in clinical examination.
- Ultrasound findings supporting diagnosis, such as gallbladder wall thickening, pericholecystic fluid, or gallstones obstructing the cystic duct.
These features together raise suspicion of acute cholecystitis and warrant urgent hospital admission for confirmation and management, including imaging and blood tests, as well as surgical assessment NICE CKS.