Which tests and medications are indicated to confirm the physical findings of an abdominal exam?

Updated: Dec 02, 2020
  • Author: Simon S Rabinowitz, MD, PhD, FAAP; Chief Editor: Kurt E Roberts, MD  more...
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Often, the patient with abdominal pathology requires diagnostic investigations to confirm the physical findings from an examination as well as to quantitatively measure the pathology. For issues that require characterization of an anatomic entity, such as hepatomegaly, abdominal mass, biliary colic, or ovarian cyst(s), an abdominal, and perhaps pelvic, sonogram is an inexpensive, safe initial investigation.

If further definition is required or if the operator is inexperienced, then either a CT scan or MRI can be performed. This will depend on the availability of the equipment, the radiologist, and the personnel to provide adequate and safe sedation, if required. Laboratory investigations should be used judiciously and includes a CBC count (to evaluate for evidence of inflammation and/or bleeding), a comprehensive metabolic profile (to evaluate for hepatic, renal dysfunction), calculation of an anion gap (to evaluate for ischemia, diabetic ketoacidosis, ingestions, inborn errors of metabolism or sepsis) (see the Anion Gap calculator), an amylase (to evaluate for pancreatitis), and an ESR (marker for inflammation including infection, neoplasia, vasculitis, autoimmune phenomenon). A urinanalysis is required to diagnose urinary tract infection, calculi, and trauma.

Although no medications are required during or related to the performance of the abdominal examination, specific diagnoses based on the physical examination may require pharmacologic agents in order to resolve. These are discussed in the individual disease sections.

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