Diagnostic peritoneal lavage in intra-abdominal sepsis

Area of Science:

• Surgical diagnosis
• Intensive Care Unit (ICU) medicine
• Diagnostic procedures

Background:

• Diagnosing surgical abdomen in critically ill patients presents challenges due to unreliable physical examinations.
• Cardiopulmonary instability and mental obtundation in ICU patients complicate traditional diagnostic methods.

Purpose of the Study:

• To evaluate the diagnostic utility of diagnostic peritoneal lavage (DPL) for intra-abdominal surgical disease.
• To assess the sensitivity and specificity of DPL in a challenging patient population.

Main Methods:

• Retrospective analysis of 44 ICU patients undergoing DPL.
• Inclusion criteria required autopsy or laparotomy confirmation of DPL findings.
• DPL was performed when physical examination was unreliable.

Main Results:

• Diagnostic peritoneal lavage demonstrated 100% sensitivity and 88% specificity.
• Three false-positive DPL results were identified out of 23 positive lavages.
• No false-negative DPL results were found in 21 negative lavages.

Conclusions:

• A negative diagnostic peritoneal lavage is highly reliable in excluding intra-abdominal surgical disease.
• Positive DPL results may necessitate additional diagnostic procedures for confirmation.