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jueves, 8 de septiembre de 2016

Abdominal Pain Labs

An online community of practice for Canadian EM physicians
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.