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Diagnosis of small intestinal microperforation by cell morphology detection in abdominal puncture fluid: A case

Yaqin Zheng1, Zijun Li2, Qinbing Zhou3

  • 1Clinical laboratory centre of Longquan People's Hospital Affiliated to Lishui University, Longquan City, Zhejiang Province, China.

International Journal of Surgery Case Reports
|February 2, 2024
PubMed
Abstract

Insights

Cellular morphology examination of diagnostic abdominal puncture fluid (DAPF) or diagnostic peritoneal lavage (DPL) offers a rapid and effective method for diagnosing small intestinal perforation, particularly after blunt abdominal trauma (BAT). This technique proves valuable when initial imaging is inconclusive.

Area of Science:

  • Trauma surgery
  • Diagnostic cytology
  • Gastrointestinal injury

Background:

  • Early diagnosis of small intestinal microperforation is crucial for patient prognosis.
  • Abdominal computed tomography angiography (CTA) is often considered the gold standard but can miss subtle injuries.
  • Delayed diagnosis of gastrointestinal trauma significantly worsens outcomes.

Observation:

  • A case report details a patient with blunt abdominal trauma (BAT) initially negative for perforation on CTA.
  • The patient developed persistent fever and septic shock post-surgery.
  • Diagnostic abdominal puncture fluid (DAPF) cell morphology examination ultimately identified intestinal perforation.

Findings:

  • Cellular morphology of DAPF/DPL can reveal specific diagnostic components indicative of intestinal perforation.
  • This method provides a rapid and convenient assessment of intra-peritoneal conditions.
  • The examination of abdominal puncture fluid offers unexpected clinical insights.

Implications:

  • Cellular morphology examination of DAPF/DPL is proposed as the simplest, fastest, and most effective diagnostic tool for small intestinal perforation in BAT.
  • The diagnostic utility of DAPF/DPL in traumatic gastrointestinal injury should not be underestimated.
  • This approach offers a vital alternative or adjunct to imaging in diagnosing critical abdominal trauma.
Keywords:
Blunt Abdominal Trauma (BAT)Cell morphology examinationDiagnosisDiagnosis of abdominal puncture fluid (DAPF)Diagnostic peritoneal lavage (DPL)Small intestinal perforation

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