The following investigations may be selected:

• haemoglobin—anaemia with chronic blood loss, e.g. peptic ulcer, carcinoma, oesophagitis

• blood film—abnormal red cells with sickle cell disease

• white cell count—leucocytosis with appendicitis (75%), 2 acute pancreatitis, mesenteric adenitis (first day only), cholecystitis (especially with empyema), pyelonephritis

• ESR—raised with carcinoma, Crohn's disease, abscess, but non-specific

• C reactive protein (CRP)—use in diagnosing infection, inflammation, e.g. pancreatic

• liver function tests—hepatobiliary disease

• serum amylase—if raised to greater than 5 times normal upper level acute pancreatitis is most likely; also raised partially with most intraabdominal disasters, e.g. ruptured ectopic, perforated peptic ulcers, ruptured empyema of gall bladder, ruptured aortic aneurysm

• pregnancy tests—urine and serum b HCG: for suspected ectopic

o blood: ureteric colic (stone or blood clot), urinary infection o white cells: urinary infection, appendicitis (bladder irritation) o bile pigments: gall bladder disease o porphobilinogen: porphyria (add Ehrlich's aldehyde reagent) o ketones: diabetic ketoacidosis o air (pneumaturia): fistula, e.g. diverticulitis, other pelvic abscess, pelvic carcinoma

• faecal blood—mesenteric artery occlusion, intussusception ('redcurrant jelly'), carcinoma colon, diverticulitis, Crohn's disease and ulcerative colitis

Back Pain Relief

Back Pain Relief

This informational eBook will present you with the most recent research and findings available so that you can learn more about Back Pain relief, covering as many bases as possible from A to Z.

Get My Free Ebook

Post a comment