[Diagnosis of intra-abdominal bleeding--comparison of peritoneal lavage and laparoscopy]

By peritoneal lavage, patients with abdominal trauma can be categorizied into: I. strongly positive = frank bleeding into the abdominal cavity; II. negative = no danger of bleeding; III. only small amounts of blood staining the lavage = watching policy by repeating the peritoneal lavage. Out of 132 PL, 33 were not conclusive in the first attempt. During the course, 9 of these had to be operated upon, whereas 24 could be spared a laparotomy by our watching policy. As to accuracy, there is no doubt that peritoneal lavage is outstanding and cannot be outweighed by laparoscopy. The same is true as to rapidity. In a retrospective study concerning 100 patients with blunt abdominal trauma and intraabdominal bleeding, we found that with peritoneal lavage 75% could be diagnosed within two hours following admittance, whereas our laparoscopy team reached the same in only 26% of the patients.