Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (196 page)

CHOLECYSTITIS, CHRONIC

   May be mild laboratory findings of acute cholecystitis or no abnormal laboratory findings

   May be laboratory findings of associated cholelithiasis

   Laboratory findings of sequelae (e.g., carcinoma of the gallbladder)

CHOLEDOCHOLITHIASIS

   Gallstones in bile ducts due to passage from the gallbladder or anatomic defects (e.g., cysts, strictures)

   Laboratory Findings

   
Core laboratory
: Increased serum and urine amylase. Increased serum bilirubin in about one third of patients. Increased urine bilirubin in about one third of patients. Increased serum ALP

   
Hematology
: Increased WBC

   Considerations

   Laboratory evidence of fluctuating or transient cholestasis. Persistent increase of WBC, AST, and ALT suggests cholangitis.

   Laboratory findings due to secondary cholangitis, acute pancreatitis, obstructive jaundice, stricture formation, and so on.

   In duodenal drainage, crystals of both calcium bilirubinate and cholesterol (some patients); 50% accurate (only useful in nonicteric patients).

   Cholelithiasis

   Laboratory findings of underlying conditions causing