Which medical condition is indicated by the presence of severe right upper quadrant pain and a positive Murphy sign?

Severe right upper quadrant pain coupled with a positive Murphy sign is indicative of acute cholecystitis. The Murphy sign refers to the discomfort or pain felt by a patient during deep inspiration when the examiner palpates the right upper quadrant, specifically over the area of the gallbladder. This clinical finding is particularly associated with inflammation of the gallbladder.

Acute cholecystitis typically arises due to a blockage of the cystic duct, most commonly by gallstones, leading to gallbladder distention and inflammation. The characteristics of severe pain, often described as sharp or colicky, along with the positive Murphy sign, collectively point towards this condition as they signify the gallbladder's irritation and potential infection.

While other conditions like gallbladder gangrene may also be serious, they would not typically present only with a positive Murphy sign without additional symptoms or findings. Cholelithiasis (gallstones) refers to the presence of stones but does not inherently cause the inflammation and pain needed to elicit a Murphy sign. Cholesterolosis involves abnormal deposits of cholesterol within the gallbladder wall but is usually asymptomatic and would not lead to acute clinical signs like those present in cholecystitis.