Bowel obstruction laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Laboratory findings consistent with the diagnosis of bowel obstruction include hyponatremia and hypokalemia, leukocytosis, metabolic alkalosis and elevated serum lactate.

Laboratory findings that may be carried out in order to diagnose bowel obstruction include:^[1]^[2]^[3]

Complete blood count
- To identify anemia, which may indicate a specific etiology such as Crohn's disease, Meckel's diverticulum or malignancy
- To identify leukocytosis
Blood urea nitrogen
- May be elevated indicating renal failure
Creatinine
- May be elevated indicating renal failure
Eletrolytes
- The presence of hyponatremia and hypokalemia is often noted in cases of bowel obstruction
Arterial blood gases
- Although not routine, is useful to assess systemic signs such as hypotension and also for cases of metabolic alkalosis
Serum lactate
- Elevated serum lactate may suggest bowel ischemia
Procalcitonin
- Prognostic biomarker, elevation more than 0.57ng/ml indicates failure of non-operative management

↑ Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Yoshikawa M, Kuwano H (2004). "Clinical studies of strangulating small bowel obstruction". Am Surg. 70 (1): 40–4. PMID 14964545.
↑ Murray MJ, Gonze MD, Nowak LR, Cobb CF (1994). "Serum D(-)-lactate levels as an aid to diagnosing acute intestinal ischemia". Am. J. Surg. 167 (6): 575–8. PMID 8209931.
↑ Lange H, Jäckel R (1994). "Usefulness of plasma lactate concentration in the diagnosis of acute abdominal disease". Eur J Surg. 160 (6–7): 381–4. PMID 7948358.