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martes, 10 de noviembre de 2015

Dolor abdominal: laboratorio

Boring EM - Posted by David Wonnacott on 2015, 11, 09
The Question
Which laboratory investigations are useful in patients with undifferentiated acute abdominal pain?
The Bottom Line
  • All pre-menopausal women should have a beta HCG test.
  • The white blood cell count and CRP are correlated with illness severity, but cannot be relied upon in isolation to rule in or out serious disease.
  • Elevated serum lipase is specific for pancreatitis, but not sensitive enough to rule it out conclusively.
  • Biliary colic and acute cholecystitis do not have sensitive or specific laboratory findings. The sensitivity and specificity of the classic laboratory findings of acute cholangitis haven’t been thoroughly studied.
  • Liver enzymes are reasonably sensitive and specific (especially ALT) for hepatic injury, but hepatic injury itself has a long differential diagnosis.
  • Hematuria is associated with renal colic, but is of limited usefulness in isolation.
  • The history and physical exam are key in determining the cause of acute undifferentiated abdominal pain.
http://boringem.org/2015/11/09/medical-concept-abdominal-pain-labs/