Related Experiment Videos
Is diagnostic peritoneal lavage for blunt trauma obsolete?
M L Hawkins1, R L Bailey, R P Carraway
1Department of Surgery, Medical College of Georgia, Augusta 30912.
The American Surgeon
|February 1, 1990
Summary
Diagnostic peritoneal lavage (DPL) is a safe, accurate, and cost-effective method for evaluating blunt abdominal trauma. This study found DPL to be 97% accurate, supporting its continued use in trauma assessment.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Diagnostic Imaging
Background:
- Blunt abdominal trauma presents diagnostic challenges.
- Computerized tomography (CT) is a recent advancement in detecting intra-abdominal injuries.
- Diagnostic peritoneal lavage (DPL) has been a standard diagnostic tool.
Purpose of the Study:
- To evaluate the accuracy, safety, speed, and cost-effectiveness of DPL.
- To determine if DPL justifies its continued use in evaluating blunt abdominal trauma.
- To compare DPL with CT in managing trauma patients.
Main Methods:
- A retrospective review of 415 DPLs performed on 414 patients over five years.
- Open technique DPL with defined criteria for gross and microscopic positivity.
- Analysis of DPL results, including false positives, false negatives, and complications.
Main Results:
- DPL demonstrated 97% accuracy with a 1% false negative rate and 2% false positive rate.
- No cases showed elevated bilirubin, amylase, or bacteria; rare vegetable fibers led to false positives.
- DPL was found to be rapid, safe, and less disruptive than CT, with lower associated fees.
Conclusions:
- Diagnostic peritoneal lavage is accurate, safe, and cost-effective for evaluating blunt abdominal trauma.
- DPL's speed and minimal disruption to patient care support its role in trauma resuscitation.
- DPL remains a preferred diagnostic procedure for adult blunt abdominal trauma.