ICU management of patients with suspected positive findings of diagnostic peritoneal lavage following blunt abdominal trauma.
OBJECTIVE
To explore the management for blunt abdominal trauma victims with probable positive diagnostic peritoneal lavage (DPL) findings.


METHODS
Data of 76 patients with probable positive DPL findings accepted to ICU in previous 10 years were reviewed. After admission, the patients were evaluated in a settled time according to the protocols of Advanced Trauma Life Support (ATLS). Vital signs were continuously monitored and DPL, ultrasound and/or CT scan were repeated when necessary.


RESULTS
Eighteen (24%) of 76 patients presented positive DPL findings after repeated DPL. Surgical findings confirmed 7 cases of spleen rupture, 3 hepatorrhexis (infra-Glisson capsule), 4 intestinal perforation, 2 gastric perforation, 1 colon perforation and 1 injured mesentery.


CONCLUSIONS
Patients with probable positive DPL findings were admitted to ICU with vital signs continuously monitored. Repeated DPL with supplemental ultrasound and/or CT scan can work together to increase the sensitivity and accuracy of the diagnosis, reduce the rate of exploratory laparotomy, ensure patients' safety and provide a reliable basis for therapeutic operations.
Gou
Dong-yuan
DY
Intensive care unit, Affiliated Sir Run Run Shaw Hospital, Medical College, Zhejiang University, Hangzhou 310016, China. goudoy123@msn.com
Jin
Yan
Y
Chen
Li-ying
LY
Wei
Qi
Q
D000007:Abdominal Injuries / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*