Is it acute cholecystitis?

In a prospective study of 100 patients presenting with acute right hypochondrial pain and diagnosed clinically by a qualified surgeon as having acute cholecystitis, we have shown that the diagnostic error can be considerable. Twenty-five of these patients were found to have a different diagnosis on subsequent investigation and in a further 11 patients, no definite diagnosis could be established. This emphasises the need for careful investigation of patients with this presenting complaint.