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  • Acute Calcular Cholecystitis Protocol Diagnosis Algorithm

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    azhar shabbir
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    This document outlines the steps for evaluating and managing a patient with suspected acute calculcular cholecystitis. It describes collecting a history and performing a physical exam looking for local and systemic signs of inflammation. Laboratory tests including a CBC, LFTs, electrolytes, amylase, lipase, and CRP should be requested. An ultrasound of the abdomen and pelvis should also be requested to check for signs of cholecystitis like gallbladder wall thickening or stones. If ultrasound confirms features of cholecystitis, the diagnosis of acute calculcular cholecystitis is confirmed and IV fluids, antibiotics, and analgesics should be initiated along with keeping the patient NPO.

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    This document outlines the steps for evaluating and managing a patient with suspected acute calculcular cholecystitis. It describes collecting a history and performing a physical exam looking for local and systemic signs of inflammation. Laboratory tests including a CBC, LFTs, electrolytes, amylase, lipase, and CRP should be requested. An ultrasound of the abdomen and pelvis should also be requested to check for signs of cholecystitis like gallbladder wall thickening or stones. If ultrasound confirms features of cholecystitis, the diagnosis of acute calculcular cholecystitis is confirmed and IV fluids, antibiotics, and analgesics should be initiated along with keeping the patient NPO.

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    5 views1 page

    Acute Calcular Cholecystitis Protocol Diagnosis Algorithm

    Uploaded by

    azhar shabbir
    This document outlines the steps for evaluating and managing a patient with suspected acute calculcular cholecystitis. It describes collecting a history and performing a physical exam looking for local and systemic signs of inflammation. Laboratory tests including a CBC, LFTs, electrolytes, amylase, lipase, and CRP should be requested. An ultrasound of the abdomen and pelvis should also be requested to check for signs of cholecystitis like gallbladder wall thickening or stones. If ultrasound confirms features of cholecystitis, the diagnosis of acute calculcular cholecystitis is confirmed and IV fluids, antibiotics, and analgesics should be initiated along with keeping the patient NPO.

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    © All Rights Reserved
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    of 1

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    Acute Calcular Cholecystitis

    Physical Request Initiate Request Imaging


    History Investigations
    Examination Management

    Request an ultrasound of
    Local Signs of Systemic signs of - CBC abdomen and pelvis
    History of Inflammation Inflammation NPO
    abdominal pain - LFTs
    suggestive of - Electrolytes
    acute and RFTs
    Murphy's Sign Fever - Amylase / - Thickening of the gallbladder wall by
    cholecystitis IV Fluids
    Lipase ≥5mm
    - CRP 1ml/kg/hr
    Elevated WBC - Presence of stones or sludge
    RUQ mass / pain /
    Pre-existing history tenderness
    Elevated CRP - Ultrasonographic Murphy’s sign
    of gallstones IV Antibiotic
    - Pericholecystic fluid

    Previous interventions
    (ERCP/Stent) IV Analgesic

    Previous recurrent biliary colic /


    pancreatitis / obstructive jaundice

    1 Local Sign of Inflammation


    + CONFIRMED
    + Ultrasound features of ACUTE
    1 Systemic Sign of Inflammation Cholecystitis CHOLECYSTITIS
    ______________________________________
    Suspected Acute Cholecystitis

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