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Diagnostic peritoneal lavage in acute peritonitis
F A Larson1, C C Haller, R Delcore
1Department of Surgery, University of Kansas Medical Center, Kansas City 66160-7308.
American Journal of Surgery
|November 1, 1992
Summary
Diagnostic peritoneal lavage (DPL) is valuable for evaluating acute peritonitis. A high white blood cell count in lavage fluid strongly indicates peritonitis, aiding clinical diagnosis.
Area of Science:
- Abdominal Surgery
- Diagnostic Procedures
- Emergency Medicine
Background:
- Acute peritonitis presents diagnostic challenges.
- Accurate diagnosis is crucial for timely surgical intervention.
Purpose of the Study:
- To assess the diagnostic utility of diagnostic peritoneal lavage (DPL) in patients with suspected acute peritonitis.
- To correlate DPL findings with intraoperative confirmation of peritonitis.
Main Methods:
- Prospective study of 50 patients (45 with suspected peritonitis, 5 controls).
- Open technique DPL performed in the operating room before laparotomy.
- Lavage fluid analyzed for cell counts, amylase, protein, bilirubin, and pH.
- Data analyzed using multiple logistic regression.
Main Results:
- 32 of 45 patients with clinical peritonitis had the diagnosis confirmed surgically.
- A white blood cell count >= 200 cells/mm3 in lavage fluid predicted peritonitis with 99% probability.
- DPL demonstrated high sensitivity and specificity for diagnosing acute peritonitis.
Conclusions:
- Diagnostic peritoneal lavage is an effective method for evaluating acute peritonitis.
- Elevated white blood cell counts in DPL fluid are a strong indicator of peritonitis.
- DPL can reliably guide surgical decision-making in suspected peritonitis cases.