Evaluation of diagnostic peritoneal lavage in suspected penetrating abdominal stab wounds using a dipstick technique.
The total protein content (g/l) and white blood cell count (cells/mm3) diagnostic peritoneal lavage was assessed using a urine dipstick in 46 patients with suspected penetrating abdominal stab wounds and equivocal physical examination. Those patients with a protein content greater than or equal to 1 g/l and white blood cell count of greater than 500 cells/mm3 were submitted to laparotomy while those with lower values underwent observation and repeat physical examination. In all, 26 patients had a positive lavage and significant injuries were found in 23 of these. Of 18 patients with a negative lavage, 17 were managed successfully without operation while one patient died from complications related to central venous catheterization. In two patients the lavage results were equivocal. One underwent a negative laparotomy and the remaining patient recovered uneventfully. The test has a 100 per cent sensitivity and 86 per cent specificity and provides an accurate, cheap, and rapid means of diagnosis of intra-abdominal injury in penetrating trauma.
Muckart
D J
DJ
Department of Surgery, University of Natal, Durban, South Africa.
McDonald
M A
MA
D000007:Abdominal Injuries / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D010533:Peritoneal Lavage; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011934:Reagent Strips; D012680:Sensitivity and Specificity; D014951:Wounds, Stab / Q000175:diagnosis*
D011934:Reagent Strips