Acute Abdomen: Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests.

• Small blood count
• Differential blood count
• Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin).
• Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
• Electrolytes – calcium, chloride, potassium, magnesium, sodium, phosphate.
• Pancreatic parameters – amylase, elastase (in serum and stool), lipase (serum) – to exclude pancreatitis (inflammation of the pancreas).
• Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
• Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
• Highly sensitive cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – if myocardial infarction (heart attack) is suspected.
• Pregnancy test (quantitative HCG).
• Blood grouping, etc. (for surgery preparation)
• Blood gas analysis (ABG); determination of:
  • Venous: pH, BE, HCO3 -, (lactate) [lactate ↑ = oxygen deficiency due to inhibition of aerobic glycolysis; here: VD a. intestinal ischemia]

Laboratory parameters 2nd order – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification.

• Microbiological smears and/or cultures (aerobic and anaerobic blood cultures; 2 times 2 or better 3 times 2 blood cultures); if necessary, also from venous accesses or from drains – if intravascular infections such as e.g. are suspected. Endocarditis (blood culture almost always positive); meningitis / meningitis (sensitivity (percentage of diseased patients in whom the disease is detected by the use of the test, ie a positive test result occurs) about 60%); pneumonia / pneumonia (sensitivity about 3-15%).
• Adrenal function diagnostics – ACTH, aldosterone or renin.
• Serological testing – if bacterial, viral or parasitic infections are suspected.
• Tumor markers – depending on the suspected diagnosis.