<prompt> A middle aged patients present with the complained of right hypochondrial pain. On X-ray, elevated right hemidiaphragm was seen. All of the following are the possible diagnoses except?Subphrenic abscessAcute cholecystitisPyogenic liver abscessAmoebic liver abscess in right lobe  <response>: Ans. b. Acute cholecystitis Ref: Sabiston 19e p1440-1447, 1487-1488; Schwartz 9e p1115 -1116; stylefont-size: 1.04761904761905em; font-family: Times New Roman, Times, serifCauses of Elevated HemidiaphragmAbove the diaphragmDiaphragmBelow the DiaphragmDecreased lung volume: Atelectasiscollapse Lobectomypneumonectomy Pulmonary hypoplasia Phrenic nerve palsy Diaphragmatic eventration Contralateral CVA: usually MCA distribution Abdominal tumour Subphrenic abscess Liver abscess Amebic and pyogenicRadiological findings of Acute CholecystitisUSG findings: Presence of gallstones, thickening of the GB wall 4 mm, pericholecystic fluid, GB distention, impacted stone, and a sonographic Murphys signQ focal tenderness directly over the GB.USG: IOC for diagnosing acute cholecystitisQ sensitivity 85, specificity 95.HIDA scan: Gold standardQ for diagnosing acute cholecystitisHIDA scan: No filling of GB with the radiotracer 99mTc-HIDA after 4 hours indicates an obstructed cystic ductQA normal HIDA scan excludes acute cholecystitisQ. 