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Likelihood Ratio (LR) in Emergency Medicine

5/28/2012

Is CRP correlated to CT result in the evaluation of abdominal pain?


A 74 yo/man complained of diffuse abdominal pain. The pain was intermittent and accompained by vomiting. He has no history of abdominal pain or abdominal surgery.
On examinations the patient presented non icteric, afebrile, not tachicardic. 
The abdomen was mildly distensed with midline tenderness. 
The US evidenced a normal aorta diameter. 
Abdominal x ray showed non specific bowel gas pattern. 
CRP value was 7 mg/L.


The radiologist says it is a little value to perform an abdominal CT, we see tomorrow…..










Conclusion 

CPR Is often used to evaluate abdominal pain.
The utility of this test alone is  limited. Normal CRP does not esclude a positive CT study. 
On the other hand a high level CRP does not mean a positive result, CPR became increasingly more specific as levels increased. 

What about WBC count? 



Bibliography 

JP Coyle
Is serum C-reactive protein a reliable predictor of abdomino-pelvic CT findings in the clinical setting of the non-traumatic acute abdomen?
Emerg Radiol April 2012. 

Ciro Paolillo

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