{
  "schema_version": 1,
  "kind": "condition",
  "id": "acute-cholecystitis",
  "name": "Acute Cholecystitis (Emergency Referral)",
  "category": "emergency",
  "sources": "Acute Cholecystitis - StatPearls, updated 6 July 2025 - https://www.ncbi.nlm.nih.gov/books/NBK459171/ · No dose - referral pathway, no medicine given in primary care",
  "review_status": "reviewed",
  "verified_against": "Acute Cholecystitis - StatPearls, updated 6 July 2025 - https://www.ncbi.nlm.nih.gov/books/NBK459171/ · No dose - referral pathway, no medicine given in primary care",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 36,
      "generic": "No drug therapy in primary care (Recognition & Referral)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "Same-day hospital referral. Right upper quadrant pain with nausea, vomiting and intolerance of fatty food, plus Murphy's sign - inspiratory arrest during palpation of the right upper quadrant. This is not biliary colic that has gone on longer: colic settles, cholecystitis does not, and it is accompanied by fever and systemic upset. Ultrasound is the imaging of choice but the referral does not wait for it.",
      "adult_duration": "Refer, with advice",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": null,
      "cautions": [
        "Untreated, StatPearls records gallbladder perforation as killing 30% of those it happens to.",
        "Hospital management is intravenous fluids and broad-spectrum antibiotics covering gram-negative rods and anaerobes, with laparoscopic cholecystectomy done early, on that same admission. (Acute Cholecystitis - StatPearls - NCBI Bookshelf, NBK459171) None of that is a primary-care prescription.",
        "Do not treat as biliary colic with an antispasmodic and analgesia at home once there is fever or a positive Murphy's sign.",
        "Jaundice, rigors or confusion suggest ascending cholangitis - that is an emergency admission, not a next-day referral."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Rare in children and usually acalculous or associated with haemolytic disease; refer the same day.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "acute-cholecystitis"
    }
  ]
}