Diagnostic Approach to Abdominal Pain in Young Females

Essential Laboratory Studies

A complete blood count (CBC) is essential to evaluate for infection, anemia, or other hematologic abnormalities in patients with abdominal pain, nausea, and fatigue, according to the World Journal of Emergency Surgery 1
The American College of Radiology recommends a comprehensive metabolic panel, including electrolytes, renal function, glucose, and liver enzymes, to assess for various metabolic derangements in patients with abdominal pain 2
Lactate level should be evaluated if there are concerning features for bowel ischemia or high-grade obstruction, such as severe pain, peritoneal signs, or hemodynamic instability, as suggested by the Journal of the American College of Radiology 3

Previous abdominal surgery has 85% sensitivity and 78% specificity for predicting adhesive small bowel obstruction, highlighting the importance of surgical history in patients with abdominal pain, as noted by the World Journal of Emergency Surgery 1
The presence of fever and elevated WBC raises suspicion for complications such as bowel ischemia, appendicitis, or other infectious/inflammatory processes, according to the Journal of the American College of Radiology and the World Journal of Emergency Surgery 1, 3

Vital signs, including orthostatic measurements, should be assessed to evaluate volume status and hemodynamic stability in patients with abdominal pain, as recommended by Circulation 4
Abdominal examination for distension, peritoneal signs, bowel sounds, and localized tenderness is crucial in patients with abdominal pain, as suggested by the Journal of the American College of Radiology and the World Journal of Emergency Surgery 1, 3

CT abdomen and pelvis with IV contrast is the primary imaging modality for acute abdominal pain with concerning features, such as peritoneal signs, severe pain, or abnormal labs, according to the Journal of the American College of Radiology 3
CT has high diagnostic accuracy for small bowel obstruction and can identify the cause, location, and presence of complications like ischemia, as noted by the Journal of the American College of Radiology 3

Significantly elevated liver enzymes with gastrointestinal symptoms warrant inpatient monitoring with serial liver function tests, as recommended by Praxis Medical Insights 2
Signs of bowel ischemia, complete obstruction, or peritonitis require immediate surgical consultation, according to the Journal of the American College of Radiology and the World Journal of Emergency Surgery 1, 3