title: Diagnostic peritoneal lavage in hemodynamically stable patients with lower chest or anterior abdominal stab wounds.
abstract: BACKGROUND
  Managing hemodynamically stable patients with thoracoabdominal stab wounds is still under dispute. This study aimed at discussing cut-off points of red blood cell (RBC) count in diagnostic peritoneal lavage (DPL) effluent in these patients.
  
  
  METHODS
  Three hundred and eighty-eight patients with thoracoabdominal stab wounds and hemodynamically stable status were enrolled. In cases without a clear indication of laparotomy, the peritoneal cavity was washed out with 1000 ml of normal saline and the effluent fluid was analyzed for RBC count. RBC counts of >100,000/mm3 in abdominal wounds and of >10,000/mm3 in lower chest wounds were considered as indications for exploratory laparotomy (conventional approach). New cut-off points for RBC count were calculated in backward analysis.
  
  
  RESULTS
  Sensitivity and specificity of the conventional approach were 90% and 84%, respectively. RBC counts >15,000/mm3 in abdominal wounds and >25,000/mm3 in lower chest wounds were the best cut-off points in distinguishing patients with and without need of operation, with a sensitivity and specificity of 94% and 96%, respectively.
  
  
  CONCLUSIONS
  New cut-off points of RBC count in DPL effluent may promote management of patients with thoracoabdominal stab wounds and no obvious indication for operation.
authors.affiliation: Department of Thoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Hashemzadeh
authors.forename: Kamran
authors.initials: K
authors.lastname: Mameghani
authors.forename: Rohollah F
authors.initials: RF
authors.lastname: Fouladi
authors.forename: Elnaz
authors.initials: E
authors.lastname: Ansari
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery; D000293:Adolescent; D000328:Adult; D003663:Decision Trees; D004636:Emergency Service, Hospital; D005260:Female; D006487:Hemostasis; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013898:Thoracic Injuries / Q000601:surgery; D016896:Treatment Outcome; D014421:Turkey; D014950:Wounds, Penetrating / Q000601:surgery*; D055815:Young Adult