Laboratory and Radiological Investigations and Cost-effectiveness

Abdominal pain (AP) is a very common complaint that renders it elusive to diagnose in most instances. After history and evaluation narrow the list of differential diagnoses (DD), ancillary investigations including laboratory tests and radiological modalities are ordered. Of note, these adjuncts will only help the clinician who bears a presumptive diagnosis on the mind. Non-invasive, repeatable and cost-efficient options such as ultrasound are preferred initially, although, in most instances, more specific and definitive information warrants advanced imaging techniques including computed tomography and contrast studies. Laboratory work-up needs to be tailored to the individual based on findings on evaluation. ECG, complete blood count and blood chemistry can provide inappreciable clues for specific diagnoses while none will be sufficient per se. Urinalysis and specific cultures including stool studies will expedite recognition of urinary tract infection, amebiasis and other infections when indicated. B-hCG level can prevent unwanted exposure to radiation and drug effects on an unrecognized pregnant woman. Thus, all these adjunctive investigations should be included in the management plan individualized to the patient, based on the history and evaluation findings. 

Keywords: Abdominal pain, Computed tomography, Contrast media, Diagnosis, Imaging, Laboratory tests, Physical examination, Radiological.