Leukocytosis in peritoneal lavage effluent after selected abdominal organ injury in an experimental model

Elevation of the corrected leukocyte count (Cwbc) in peritoneal lavage effluent has been reported by us in association with colon perforation. We have extended this study in order to investigate systematically the nature of the stimuli to, and the timing, magnitude, and consistency of this response in the presence of other occult abdominal injuries associated with trauma. This has been done by subjecting an anesthetized canine model to a variety of isolated intra-abdominal injuries and then measuring sequential peritoneal lavage leukocyte counts up to six hours after injury. A rising lavage leukocyte count gave Cwbc-positive lavages in 94% of animals with jejunal, ileal, and colonic wounds by six hours. In animals with isolated peritoneal penetration alone, or simple liver or spleen wounds, an elevated Cwbc count was unusual. In stomach, gallbladder, and urinary bladder perforation, a positive lavage was an inconsistent finding. Peritoneal lavage leukocyte counts corrected on the basis of red cell count can enhance the accuracy and utility of lavage for abdominal trauma, especially when gastrointestinal perforation is present as an isolated injury, by detecting an early peritoneal inflammatory response which appears independently from simple hemorrhage. [Mueller GL, Burney RE, MacKenzie JR: Leukocytosis in peritoneal lavage effluent after selected abdominal organ injury in an experimental model.