Diagnosis
Laboratory tests are not always reliable, but the following findings may be diagnostically useful:
Leukocytosis with a left shift may be observed
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels may be elevated in cholecystitis or with common bile duct (CBD) obstruction
Bilirubin and alkaline phosphatase assays may reveal evidence of CBD obstruction
Amylase/lipase assays are used to assess for pancreatitis; amylase may also be mildly elevated in cholecystitis
Alkaline phosphatase level may be elevated (25% of patients with cholecystitis)
Urinalysis is used to rule out pyelonephritis and renal calculi
All females of childbearing age should undergo pregnancy testing