Acute Cholecystitis Diagnosis (Tokyo Guidelines TG18)

Acute cholecystitis diagnosis (Tokyo Guidelines TG18/TG13, Yokoe 2018): classifies a presentation as definite, suspected, or not-met from three categories.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

A Murphy's sign
Yes
B fever
Yes

Result: Suspected acute cholecystitis (TG18): one item in category A (Murphy sign) plus one in B (fever); a definite diagnosis adds a characteristic imaging finding.

The tool opens with these values already filled in. Replace them with your own.

What the result means

Suspected
One item in A (local signs) plus one item in B (systemic signs).
Definite
One item in A plus one in B plus C (imaging findings characteristic of acute cholecystitis).
Not met
Fewer items than the suspected threshold; the presentation does not meet TG18 criteria.

What you enter

  • A Murphy's sign
  • A right-upper-quadrant mass, pain, or tenderness
  • B fever
  • B elevated CRP
  • B elevated WBC count
  • C imaging findings characteristic of acute cholecystitis
How this is calculated

Miura F, Okamoto K, Takada T, et al. Tokyo Guidelines 2018: initial management of acute biliary infection and flowchart for acute cholangitis. J Hepatobiliary Pancreat Sci. 2018;25(1):31-40 (Table 2, cited from Yokoe et al.). Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.