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Diagnostic criteria for acute cholecystitis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The Tokyo Guidelines (TG13/TG18) for the management of acute cholangitis and cholecystitis proposed the following as diagnostic criteria for acute cholecystitis:


A. Local signs of inflammation, etc.:
(1) Murphy's sign, (2) RUQ mass/pain/tenderness

B. Systemic signs of inflammation, etc.:
(1) Fever, (2) elevated CRP, (3) elevated WBC count

C. Imaging findings: imaging findings characteristic of acute cholecystitis

Suspected diagnosis:

  • one item in A+ one item in B

Definite diagnosis:

  • one item in A+ one item in B + C

Note: acute hepatitis, other acute abdominal disease, and chronic cholecystitis should be excluded

Reference:

  1. Yokoe M, et al.Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):41-54. doi: 10.1002/jhbp.515. Epub 2018 Jan 9. PMID: 29032636.

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