Acute cholecystitis is diagnosed by a combination of:
1. Hisotry of right sided abdominal pain. This may radiate to the back and may be associated with nausea and vomiting. Usually starts after a fatty meal.
2. Blood tests may show raised markers of inflammation such as CRP and white cell count. Occasionally the liver function tests may be abnormal if there is a gallstone that has moved into the common bile duct
3. Ultrasound scan will most likely show a thick walled gallbladder, gallstones and fluid around the gallbladder
4. CT scan may show a thick walled gallbladder but is less sensitive for showing gallstones as most are not radioopaque.
5. A HIDA scan can be performed if the diagnosis is in doubt. It is a functional test of the gallbladder. It is a very sensitive test for acute cholecystitis but rarely needs to be performed.
Once the diagnosis has been confirmed, depending on various factors including the number of days from when the attack started, general health of the patient and presence or abscence of stones in the common bile duct, further treatment can be advised.