Blood test and urgent abdominal conditions

Clinical Scenario

A 44 YO man presents to the ED complaining of abdominal pain. He was well until 4 hours ago, when he developed diffuse abdominal pain. This is the first time he suffers abdominal pain. He has not history of surgery.

The patient is afebrile, HR is 80, BP is 180/100, ECG is normal. The abdomen is very painful, but soft.

Is it a serious condition? Asks the worried man.

“We’ll see later, after blood test” says the doctor. 

Conclusion 

WBC count and CRP levels alone or together are insufficient markers to be used as a triage instruments to select an urgent from non-urgent abdominal condition. In several circumstances like acute appendicitis or acute diverticulitis o cholecystitis WBC count and CRP levels can be normal.

Blood test alone are of limited use. 

   

Bibliography 

SL Gans

C-Reactive protein and white blood cell count as triage test between urgent and non urgent conditions in 2961 patients with acute abdominal pain. 

Medicine 2015 vol 94 n 9 1-9.

C Paolillo, I.Spallino

Can C-reactive protein and white blood cell count alore rule out an urgent condition in acute abdominal pain?

Intern Emerg Med 2015 oct 27.

Ciro Paolillo