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Algorithm for Acalculous Cholecystitis

  1. Plain radiographs of the abdomen to exclude bowel obstruction
  2. Abdominal ultrasound to evaluate the gallbladder and the biliary tree
  3. Tc-99m-IDA scintigraphy (HIDA scan) if ultrasound findings are equivocal and there is a high clinical suspicion of acute cholecystitis
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