Lab tests for acute abdominal pain

Which laboratory tests should be obtained in patients with acute abdominal pain? 

Although laboratory tests are helpful in confirming the evolution of a disease process, they are frequently not helpful in localizing the cause of abdominal pain.

• Obtain a complete blood count. Elevation of the white blood cell count suggests inflammation; however, absence of leukocytosis may be misleading early in the course of disease. A low hematocrit with a normal mean corpuscular volume (MCV) suggests acute blood loss, whereas a low hematocrit with a low MCV suggests iron deficiency from chronic gastrointestinal (GI) blood loss or malabsorption.

• Amylase and lipase elevations may suggest pancreatitis, but amylase can come from various other sources, including salivary glands, lung, intestine, and ovary.

• Liver enzyme elevations may be suggestive of hepatobiliary causes of pain. Elevations of aspartate or alanine aminotransferase suggest hepatocyte injury. Alkaline phosphatase or γ-glutamine transferase elevations suggest canalicular or biliary injury. Total bilirubin elevations greater than 3 mg/dL suggest common bile duct obstruction or associated intrahepatic cholestasis, but if bilirubin elevation is predominantly unconjugated and not associated with liver enzyme elevations, it may be due to Gilbert’s disease.

• Evidence of pyuria on urinalysis suggests urinary tract infection but also may be seen in nephrolithiasis prostatitis or even pelvic appendicitis.

• Chemistry analysis can be helpful in the global assessment of patient health, hyperglycemia, acidosis, and electrolyte disturbances.

• Pregnancy tests (beta human chorionic gonadotropin) should be ordered for all premenopausal women.

• Stool examination for occult blood may be useful.

• Electrocardiography is performed for all patients with possible myocardial infarction or older than 50 years.

15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top