title: Comparison of diagnostic peritoneal lavage and focused assessment by sonography in trauma as an adjunct to primary survey in torso trauma: a prospective randomized clinical trial.
abstract: BACKGROUND
  Lately, Focused Assessment with Sonography in Trauma (FAST) is preferred over diagnostic peritoneal lavage (DPL) as adjunct to primary survey. However, this is not evidence-based as there has been no randomized trial.
  
  
  METHODS
  In this study, 200 consecutive torso trauma patients meeting inclusion criteria were randomized to undergo either DPL or FAST. The results were then compared with either contrast enhanced computerized tomography (CECT) (in patients managed non-operatively) or laparotomy findings (in patients undergoing operative treatment). Outcome parameters were: result of the test, therapeutic usefulness, role in diagnosing bowel injury and time taken to perform the procedure.
  
  
  RESULTS
  Two hundred patients with a mean age of 28.3 years were studied, 98 in FAST and 102 in DPL group. 104 sustained blunt trauma and 76 sustained penetrating trauma due to stabbing. In addition, 38 (38.7%) were FAST positive and 48 (47%) were DPL positive (p=0.237, not significant). As a guide to therapeutically beneficial laparotomy, negative DPL was better than negative FAST. For non-operative decisions, positive FAST was significantly better than positive DPL. DPL was significantly better than FAST in detecting as well as not missing the bowel injuries. DPL took significantly more time than FAST to perform.
  
  
  CONCLUSIONS
  This study shows that DPL is better than FAST.
authors.affiliation: Department of Surgery, University College of Medical Sciences, Delhi, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Surgery, University College of Medical Sciences, Delhi, India.
authors.forename: Abhay
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Surgery, University College of Medical Sciences, Delhi, India.
authors.forename: Mohit Kumar
authors.initials: MK
authors.lastname: Joshi
authors.affiliation: Department of Surgery, University College of Medical Sciences, Delhi, India.
authors.forename: Vinita
authors.initials: V
authors.lastname: Rathi
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage / Q000706:statistics & numerical data; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome; D014463:Ultrasonography / Q000706:statistics & numerical data; D055815:Young Adult