-Vitals notable for tachcyardia. Overall appears in pain but non-toxic

-Patient presents with upper abdominal pain and moderate tenderness with guarding consistent with a surgical process.

-Labs notable for leukocytosis. [CT/US] concerning for acute cholecystitis. Clinical picture fits cholecystitis.

-Antibiotics and cultures ordered. Pain and nausea controlled.

-Discussed with surgeon who recommends admission for prompt surgical intervention

-These findings and the plan were discussed at length with the patient and they agreed with the plan