Giving IV potassium at faster rates (20–25 meq/hr) may inadvertently expose the heart to a sudden increase in potassium, potentially causing dangerous abnormal heart rhythms such as heart block or asystole. Faster infusion rates are therefore generally only performed in locations in which the heart rhythm can be continuously monitored such as a critical care unit. When replacing potassium intravenously, particularly when higher concentrations of potassium are used, infusion by a central line is encouraged to avoid the occurrence of a burning sensation at the site of infusion, or the rare occurrence of damage to the vein. When peripheral infusions are necessary, the burning can be reduced by diluting the potassium in larger amounts of fluid, or adding a small dose of lidocaine to the intravenous fluid, although adding lidocaine may increase the likelihood of medical errors. Even in severe hypokalemia, oral supplementation is preferred given its safety profile. Sustained-release formulations should be avoided in acute settings. Potassium-sparing diuretics
Hypokalemia which is recurrent or resistant to treatment may be amenable to a potassium-sparing diuretic, such as amiloride, triamterene, spironolactone, or eplerenone. Concomitant hypomagnesemia will inhibit potassium replacement, as magnesium is a cofactor for potassium uptake. Popular culture
The plot of the science fiction novel Destinys Road by Larry Niven centers around the settings scarcity of available potassium, and the resulting deficiency and its effects on the worlds colonists and their society.In the video game Deltarune, Queen expresses concern about one of the characters (Noelle) clipping into a wall and dying slowly from Hypokalemia.
These alternative diagnoses include but are not limited to:
Perforated peptic ulcer
Acute pancreatitis
Liver abscess
Pneumonia
Myocardial ischemia
Hiatal hernia
Biliary colic
Choledocholithiasis
Cholangitis
Appendicitis
Colitis
Acute peptic ulcer exacerbation
Amoebic liver abscess
Acute intestinal obstruction
Kidney stone
Biliary ascariasis

Treatment
Surgery
For most people with acute cholecystitis, the treatment of choice is surgical removal of the gallbladder, laparoscopic cholecystectomy. Laparoscopic cholecystectomy is performed using several small incisions located at various points across the abdomen. Several studies have demonstrated the superiority of laparoscopic cholecystectomy when compared to open cholecystectomy (using a large incision in the right upper abdomen under the rib cage). People undergoing laparoscopic surgery report less incisional pain postoperatively as well as having fewer long-term complications and less disability following the surgery. Additionally, laparoscopic surgery is associated with a lower rate of surgical site infection.During the days prior to laparoscopic surgery, studies showed that outcomes were better following early removal of the gallbladder, preferably within the first week. Early laparoscopic cholecystectomy (within 7 days of visiting a doctor with symptoms) as compared to delayed treatment (more than 6 weeks) may result in shorter hospital stays and a decreased risk of requiring an emergency procedure. There is no difference in terms of negative outcomes including bile duct injury or conversion to open cholecystectomy. For early cholecystectomy, the most common reason for conversion to open surgery is inflammation that hides Calots triangle. For delayed surgery, the most common reason was fibrotic adhesions. Other
Supportive measures may be instituted prior to surgery. These measures include fluid resuscitation. Intravenous opioids can be used for pain control.Antibiotics are often not needed.