The diagnostic and prognostic value of peritoneal lavage in patients with acute pancreatitis

Diagnostic peritoneal lavage was performed upon 247 patients referred with a clinical diagnosis of acute pancreatitis at a median time of five hours after admission to the hospital and was associated with 0.8 per cent morbidity. The procedure enabled an erroneous clinical diagnosis to be corrected in seven patients and confirmed a tentative clinical diagnosis in two other patients. Criteria for the prediction of severe pancreatitis by peritoneal lavage are described. This enabled 90 per cent of the patients who died of fulminant pancreatitis or of the later effects of pancreatic necrosis to be identified. Diagnostic lavage appeared to be most useful for the identification of severe attacks of pancreatitis which were associated with a shock-like systemic illness.