Gallstone Disease and Cholecystitis

A 58-year-old man from Bangalore presents with sudden-onset severe right upper quadrant pain, fever (39.2°C), and hypotension (BP 100/62). On examination, he is toxic-looking with severe RUQ tenderness and guarding. Ultrasound shows a large stone (2.5 cm) impacted in the gallbladder neck, marked wall thickening (6 mm), extensive pericholecystic fluid, and free intraperitoneal fluid. WBC is 16,000/μL. Serum bilirubin is 1.2 mg/dL (normal). What is the most likely diagnosis and the most appropriate immediate management?

A 52-year-old woman with acute cholecystitis (confirmed on ultrasound) presents with right upper quadrant pain, fever (38.5°C), and leukocytosis (WBC 14,000/μL). She is haemodynamically stable and has no signs of peritonitis. What is the drug of choice for initial antibiotic therapy?

A 52-year-old woman undergoes ultrasound abdomen for recurrent right upper quadrant pain. Multiple gallstones are identified. Which is the most common site of gallstone impaction leading to acute cholecystitis?

A 48-year-old Indian woman with a 10-year history of cholelithiasis presents with acute right upper quadrant pain, fever, and leukocytosis. Blood cultures grow a gram-negative rod. Which is the most common causative organism in acute bacterial cholecystitis?

A 48-year-old woman from rural Maharashtra presents with acute right upper quadrant pain, fever (38.5°C), and positive Murphy's sign. Ultrasound confirms acute cholecystitis with a thickened gallbladder wall and pericholecystic fluid. Regarding the pathophysiology and management of acute cholecystitis, which of the following is NOT true?