Diagnostic, percutaneous peritoneal lavage in blunt abdominal trauma: rationale, technique and results

The records of 90 consecutive adult patients, who presented after blunt abdominal trauma and who underwent diagnostic, percutaneous peritoneal lavage over a 3 year period, were reviewed. Lavage effluents were considered positive, negative or equivocal. An equivocal result was one where the tubing contained blood stained fluid, but it was still possible to see newsprint through the tubing. Fifty-one lavages were positive, 24 negative and 15 equivocal. All 51 patients with a positive effluent and three of the patients with an equivocal effluent had a laparotomy and in all but one case a significant injury was found. There were no false negative results. In a single patient the transverse colon was perforated during the insertion of the lavage catheter. Diagnostic, percutaneous peritoneal lavage is a simple, safe, rapidly performed, accurate technique designed to detect intraperitoneal blood and the results of this review suggest that it has a role to play in the decision-making process when assessing adult patients who have suffered blunt abdominal trauma.