When to Refer to a Gastroenterologist
Unable to make a definitive diagnosis
Need for endoscopic procedure for diagnosis
Irritable bowel syndrome refractory to standard therapy
Suspected ischemic bowel (chronic)
Suspected diverticulitis
Suspected ulcerative colitis or Crohn's disease
Suspected pancreatitis
Suspected pancreatic carcinoma
When to Refer to Other Specialists
Surgeon Acute abdomen on physical examination
Hemodynamic instability
Free intraperitoneal air on radiographs
Suspected bowel obstruction
Suspected acute mesenteric ischemia
Suspected acute appendicitis
Suspected acute cholecystitis or biliary colic
Urologist Nephrolithiasis with fever or complete ureteral obstruction
Nephrolithiasis with solitary kidney or failure to pass stone within 6 weeks
Nephrolithiasis with stone > 7 mm diameter
Gynecologist Suspected adnexal torsion
Lower abdominal pain and positive pregnancy test
Suspected pelvic inflammatory disease
Suspected endometriosis