Peritoneal lavage in penetrating injuries of the small bowel and colon: value of enzyme determinations.
The value of lavage alkaline phosphatase determinations following hollow visceral injury was studied. Twenty-nine mongrel dogs were subjected to partial transection of the small intestine or colon, or underwent sham laparotomy. Sequential diagnostic peritoneal lavage was performed. At one hour post injury the lavage red cell count, white cell count, and amylase levels were within normal limits in each group. The lavage alkaline phosphatase, however, was markedly elevated in both bowel-injured groups compared with the sham group. In the five-hour lavage, red cell counts and amylase levels remained normal. White cell counts were now elevated in all three groups, but the results did not distinguish the intestinal injury from the sham model. Lavage alkaline phosphatase was again significantly increased in the injured groups versus the sham model. Serum alkaline phosphatase and amylase levels were normal in all study groups at baseline and one and five hours post injury. This canine study demonstrates the utility of peritoneal lavage alkaline phosphatase levels in identifying isolated small intestine and colon injuries that were otherwise undetected by red cell, white cell, and amylase determinations.
D000469:Alkaline Phosphatase / Q000097:blood*; D000681:Amylases / Q000097:blood*; D000818:Animals; D003106:Colon / Q000201:enzymology / Q000293:injuries*; D004285:Dogs; D004906:Erythrocyte Count; D007421:Intestine, Small / Q000201:enzymology / Q000293:injuries*; D007958:Leukocyte Count; D010529:Peritoneal Cavity; D007507:Therapeutic Irrigation; D013997:Time Factors; D014950:Wounds, Penetrating / Q000175:diagnosis*
D000469:Alkaline Phosphatase; D000681:Amylases