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A Young Woman With an Acute Abdomen: HIV and Hepatitis B Testing?

Rob Crane, MD
JAMA. 1991;265(9):1114. doi:10.1001/jama.1991.03460090062033.
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To the Editor.—  In his answer to a Texas physician about the "preoperative evaluation of a young woman with an acute abdomen," Dr Cromer1 suggests that minimal laboratory evaluation should include several judiciously selected, reasonable diagnostic tests. He then goes on to suggest, "If the patient is unknown to the physician(s) or presumed to be at high risk, it might also be appropriate to test for hepatitis B serologies and antibodies for human immunodeficiency virus [HIV]."Because these tests are unlikely to yield any significant information pertinent to the differential diagnosis at hand, one must presume that Dr Cromer is evaluating the risk of viral transmission to the health care professionals attending this patient.2 Further, it suggests that knowledge of HIV or hepatitis B infection would significantly change the short-term treatment of this patient.There are several problems with this approach. First, it is most improbable that the


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