title: Diagnostic peritoneal lavage for diagnosing blunt hollow visceral injury: the accuracy of two different criteria and their combination.
abstract: OBJECTIVE
  To test the usefulness of diagnostic peritoneal lavage (DPL) for identifying blunt hollow visceral injury with two different sets of criteria or a combination of the two.
  
  
  METHODS
  Fifty victims with physical examinations and/or computed tomography findings equivocal for blunt hollow visceral injury underwent DPL. Whether or not to perform surgery was determined based on Otomo's DPL criteria [lavage white blood cell counts (L-WBC) over lavage red blood cell counts (L-RBC) divided by 150 (L-WBC > or = L-RBC/150) in the presence of hemoperitoneum, or L-WBC over 500/mm(3) (L-WBC > or = 500) in the absence of hemoperitoneum]. The cell count ratio, a comparison of L-WBC, L-RBC, peripheral WBC (P-WBC), and peripheral RBC (P-RBC) [(L-WBC/L-RBC)/(P-WBC/P-RBC) > or = 1] were all calculated retrospectively.
  
  
  RESULTS
  There were one and two false-positive cases based on Otomo's criteria and the cell count ratio, respectively, with corresponding accuracies of 97.8% and 95.7%, respectively. There were no false-positive or -negative cases according to the combined use of Otomo's criteria and cell count ratio, yielding an accuracy of 100%.
  
  
  CONCLUSIONS
  Although each criterion alone is very accurate in predicting the presence of blunt hollow visceral injury, the combined use of the two would further improve the accuracy of the diagnosis and thereby reduce the number of unnecessary celiotomies.
authors.affiliation: Department of Surgery, Niigata City General Hospital, Japan.
authors.forename: Tomoi
authors.initials: T
authors.lastname: Sato
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirose
authors.forename: Hideki
authors.initials: H
authors.lastname: Saito
authors.forename: Mutsuo
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Norio
authors.initials: N
authors.lastname: Katayanagi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Otani
authors.forename: Shirou
authors.initials: S
authors.lastname: Kuwabara
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Hirano
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Osamu
authors.initials: O
authors.lastname: Aizawa
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D007422:Intestines / Q000293:injuries; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014781:Viscera / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*