Diagnostic peritoneal lavage in the management of blunt abdominal trauma: a reassessment.
In order to reassess the value of diagnostic peritoneal lavage (DPL) in patients with blunt abdominal trauma, we conducted a prospective study over a 15-month period involving 138 patients. There were 29 (28.3%) patients with positive DPL and 103 (71.7%) with negative DPL in this series. Of the 29 patients with positive DPL, 28 (96.5%) were found to have significant intra-abdominal injuries; 27 by exploratory laparotomy and in one case at autopsy. One patient with a grossly positive DPL had a negative exploratory laparotomy (3.4% false positive rate). All 109 patients with negative DPL were admitted. In only one case a significant intra-abdominal injury was demonstrated (0.9% false negative rate). The overall mortality in this series was 11.6% and there were no complications related to the DPL. Our results suggest that DPL is indeed an accurate indicator of significant intra-abdominal injuries in patients with blunt abdominal trauma.
D000007:Abdominal Injuries / Q000175:diagnosis*; D005260:Female; D006465:Hemoperitoneum / Q000175:diagnosis; D006801:Humans; D007813:Laparotomy; D008297:Male; D010529:Peritoneal Cavity; D011446:Prospective Studies; D007507:Therapeutic Irrigation; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*