Which lab tests may be useful in the diagnosis of diverticulitis?

Updated: Aug 06, 2019
  • Author: Elie M Ghoulam, MD, MS; Chief Editor: BS Anand, MD  more...
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The diagnosis of acute diverticulitis can usually be made on the basis of the history and physical examination findings, but laboratory tests may be of help when the diagnosis is in question, as follows:

  • The white blood cell count may show leukocytosis and a left shift, but it may be normal in immunocompromised, elderly, or less severely ill patients.

  • A hemoglobin level is important in patients who report hematochezia.

  • Electrolyte assays may be helpful in the patient who is vomiting or has diarrhea.

  • Assess renal function prior to the administration of most intravenous contrast material.

  • Liver enzyme and lipase levels may help to exclude other causes of abdominal pain.

  • Urinalysis may reveal red or white blood cells in patients with a colovesicular fistula or with diverticulitis adjacent to the ureters or the bladder.

  • A urine culture may distinguish sterile pyuria due to inflammation from polymicrobial infection due to a fistula.

  • Obtain blood cultures prior to the administration of empiric parenteral antimicrobial therapy in patients who are severely ill or in those with complicated disease.

  • Perform a pregnancy test in any female of childbearing age with abdominal pain.

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