CanadiEM - By Wonnacott D - November 9, 2015
The Bottom Line on abdominal pain labs
- 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.