Which of the following findings is consistent with a diagnosis of acute cholecystitis?

• A. Fever and right upper quadrant tenderness
• B. Normal renal ultrasound findings
• C. Intermittent abdominal pain
• D. Non-tender abdominal exam

Answer: (A)

A diagnosis of acute cholecystitis is typically supported by specific clinical findings, and the combination of fever and right upper quadrant tenderness is particularly significant. Acute cholecystitis is often due to obstruction of the cystic duct, most commonly caused by gallstones. This obstruction leads to inflammation of the gallbladder, which frequently presents with classic signs.

Fever is a response to the inflammatory process, while tenderness in the right upper quadrant is a direct manifestation of gallbladder irritation and inflammation. Patients may also exhibit rebound tenderness or guarding during a physical examination, indicating peritoneal irritation. These findings are essential for clinicians to consider in diagnosing acute cholecystitis, alongside other diagnostic tools like ultrasound or CT scans to confirm gallbladder inflammation.

Other choices do not align with the typical presentation of acute cholecystitis. Normal renal ultrasound findings wouldn't address the gallbladder pathology necessary for a diagnosis. Intermittent abdominal pain is more suggestive of a chronic condition or other gastrointestinal issues rather than the acute, constant pain often associated with cholecystitis. Lastly, a non-tender abdominal exam would not typically correlate with acute cholecystitis, as tenderness is a hallmark of this condition.