Patients with acute abdominal pain: white cell and neutrophil counts as predictors of the surgical acute abdomen.

Two hundred and fifty-two patients with acute abdominal pain were admitted to Wellington Hospital during three consecutive months in 1982. The prevalence of the surgical acute abdomen in these patients was 35%. There was no significant difference in performance between the peripheral blood white cell count (WCC) and neutrophil count (NC) when used as diagnostic tests of surgical acute abdomen. Neither test is sufficiently sensitive or specific to be a good predictor of surgical acute abdomen. It is recommended that the WCC be used sparingly and interpreted as a continuously distributed rather than dichotomous diagnostic test. There is no advantage in using the NC.