Which of the following statement(s) is/are true concerning laboratory tests which might be obtained in the patient discussed above?

d. There is no rapidly available test to distinguish tissue necrosis from simple bowel obstruction

There have been multiple attempts to use common clinical laboratory test criteria to identify the likelihood that obstruction is associated with strangulation. In most cases of simple obstruction, laboratory studies do not play a direct role in diagnosis but are helpful in understanding the extent of complications such as dehydration and fluid and electrolyte abnormalities. An elevation of the white blood cell count along with fever, tachycardia, and localized abdominal tenderness is one of the “cardinal signs” for risk for strangulation. However, such an elevation is nonspecific. Similarly, metabolic acidosis may be associated with intestinal ischemia as well as evidence of dehydration and fluid loss. Elevation of BUN and other electrolyte abnormalities also represent fluid loss and dehydration. Therefore, at present there is no non-invasive rapid laboratory tests that can provide information to suggest that tissue necrosis is eminent.