Algorithm for Acute Cholecystitis

1. Supine and upright abdominal plain radiographs 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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