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Related Experiment Videos

Peritoneal lavage white count: a reassessment.

D G Jacobs1, L Angus, A Rodriguez

  • 1Department of Surgery, Maryland Institute for Emergency Medical Services Systems, Baltimore 21201-1595.

The Journal of Trauma
|May 1, 1990
PubMed
Summary

Diagnostic peritoneal lavage white blood cell count (DPL:WBC) is not a reliable sole indicator for diagnosing intestinal perforation in blunt trauma patients. Further research is needed to clarify the role of sequential DPL:WBC measurements.

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Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Surgical Diagnostics

Background:

  • Blunt abdominal trauma poses diagnostic challenges, particularly in identifying occult intestinal perforation.
  • Diagnostic peritoneal lavage (DPL) is an invasive procedure used to assess intra-abdominal injuries.
  • The interpretation of DPL findings, specifically white blood cell count (WBC), requires further validation.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of elevated DPL:WBC as the sole criterion for intestinal perforation in blunt trauma.
  • To assess the clinical significance of DPL:WBC in patients with blunt abdominal trauma.

Main Methods:

  • Retrospective review of blunt trauma patients meeting specific DPL:WBC criteria.
  • Clinical follow-up of patients managed non-operatively after positive DPL.

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  • Comparison of DPL findings with eventual diagnosis in patients with confirmed intestinal perforation.

    • Main Results:

    • Only 1 of 29 patients with DPL:WBC ≥ 500/mm³ as the sole positive criterion had intestinal perforation.
    • None of the 23 patients followed clinically after non-operative management developed intestinal perforation.
    • In patients with confirmed intestinal perforation, elevated DPL:WBC alone was rarely the diagnostic factor.

    Conclusions:

    • Elevated DPL:WBC is a nonspecific finding and not a reliable sole indicator for intestinal perforation in blunt trauma.
    • Prospective studies are necessary to define the precise role of DPL:WBC in diagnosing intestinal perforation.
    • Sequential DPL:WBC measurements may offer improved diagnostic utility.