Diagnostic peritoneal lavage: accuracy in predicting necessary laparotomy following blunt and penetrating trauma.
The purpose of this study was to evaluate the ability of diagnostic peritoneal lavage (DPL) to predict intra-abdominal injuries that required surgical repair. To do this, we retrospectively reviewed 944 patients with blunt and penetrating abdominal trauma who underwent 975 DPLs. Initial DPL in 608 patients sustaining blunt trauma had a sensitivity of 87%, a specificity of 97%, an accuracy of 95%, a positive predictive value (PPV) of 85%, and a negative predictive value (NPV) of 97%. Initial DPL in 336 patients with penetrating trauma had a sensitivity of 87%, a specificity of 89%, an accuracy of 89%, a PPV of 75%, and a NPV of 95%. When utilizing final lavage results on the 944 patients, DPL had a sensitivity of 91%, a specificity of 94%, an accuracy of 93%, a PPV of 80%, and a NPV of 98% in predicting intra-abdominal injury requiring surgical repair.
Henneman
P L
PL
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance 90509.
Marx
J A
JA
Moore
E E
EE
Cantrill
S V
SV
Ammons
L A
LA
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D015994:Incidence; D007813:Laparotomy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000592:standards*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery