title: Hollow organ perforation in blunt abdominal trauma: the role of diagnostic peritoneal lavage.
abstract: BACKGROUND
  With recent advances in radiologic diagnostic procedures, the use of diagnostic peritoneal lavage (DPL) has markedly declined. In this study, we reviewed data to reevaluate the role of DPL in the diagnosis of hollow organ perforation in patients with blunt abdominal trauma.
  
  
  METHODS
  Adult patients who had sustained blunt abdominal trauma and who were hemodynamically stable after initial resuscitation underwent an abdominal computed tomographic (CT) scan. Diagnostic peritoneal lavage was performed for patients who were indicated to receive nonoperative management and where hollow organ perforation could not be ruled out.
  
  
  RESULTS
  During a 60-month period, 64 patients who had received abdominal CT scanning underwent DPL. Nineteen patients were diagnosed as having a positive DPL based on cell count ratio of 1 or higher. There were 4 patients who sustained small bowel perforation. The sensitivity and specificity of the cell count ratio for a hollow organ perforation in this study were 100% and 75%, respectively. No missed hollow organ perforations were detected.
  
  
  CONCLUSIONS
  For patients with blunt abdominal trauma and hemoperitoneum who plan to receive nonoperative management, DPL is still a useful tool to exclude hollow organ perforation that is undetected by CT.
authors.affiliation: Trauma and Emergency Center, China Medical University Hospital, Taichung 404, Taiwan. traumawang@yahoo.com.tw
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Wang
authors.forename: Chi-Hsun
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Fu
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yeh
authors.forename: Shih-Chi
authors.initials: SC
authors.lastname: Wu
authors.forename: Ray-Jade
authors.initials: RJ
authors.lastname: Chen
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000000981:diagnostic imaging; D055815:Young Adult