Rational Diagnostic Procedures

Abstract

When treating a patient with acute abdominal pain, it is tempting to make extensive use of ancillary investigations. This leads to the emergence of “routines” in the emergency room (ER), by which every patient with acute abdominal pain undergoes a plain X-ray of the abdomen (AXR) and a series of blood tests, which typically include a complete blood count, routine blood chemistry, and serum amylase. These “routine” tests have a very low diagnostic yield and are not cost effective. However, they are also an unavoidable part of life in the ER and are often obtained before the surgical consultation.

Asher Hirshberg, MD, contributed to this chapter in the first edition of the book.