Is diagnostic peritoneal lavage for blunt trauma obsolete?

M. L. Hawkins, R. L. Bailey, R. P. Carraway

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Diagnostic peritoneal lavage was 97 percent accurate, with a 2 percent false positive rate and a 1 percent false negative rate in this series of 414 patients. The ease, safety, and accuracy of diagnostic peritoneal lavage justify its continued use in evaluating these patients. Recent studies show computerized tomography (CT) can be highly accurate in detecting intra-abdominal injuries after blunt trauma. We reviewed our experience with diagnostic peritoneal lavage (DPL) to evaluate whether the accuracy, safety, speed, and cost justified its continued use. Four hundred fifteen DPLs were performed on 414 patients from February 1, 1983, through December 31, 1987. All DPLs were done by the open technique. The lavage was considered grossly positive if 10 cc gross blood were aspirated. If there were greater than 100,000 red blood cells (RBC)/mm3, greater than 500 white blood cells (WBC)/mm3, elevated amylase or bilirubin, or bacteria or vegetable fibers the lavage was microscopically positive. There were no cases with elevated bilirubin, amylase, or presence of bacteria. All four cases with 'rare vegetable fibers' were false positive. Six DPLs were for penetrating trauma to the lower five false negatives (1%), and 124 positive DPLs, including seven false positives (2%), resulting in a crude accuracy of 97 percent. Three of the five false negative lavages had a ruptured diaphragm as the only intra-abdominal injury. There was one minor complication. DPL was usually performed in the trauma resuscitation room during the secondary survey. At our institution, the total fees for DPL are $185 less than the fees for CT. DPL is accurate, rapid, safe, and avoids the disruption of patient care that results in the radiology suite. DPL remains our procedure of choice for evaluating blunt abdominal trauma in the adult.

Original languageEnglish (US)
Pages (from-to)96-99
Number of pages4
JournalAmerican Surgeon
Volume56
Issue number2
StatePublished - Jan 1 1990

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Peritoneal Lavage
Wounds and Injuries
Therapeutic Irrigation
Abdominal Injuries
Fees and Charges
Amylases
Bilirubin
Vegetables
Tomography
Bacteria
Safety
Diaphragm
Radiology
Resuscitation
Patient Care
Leukocytes
Erythrocytes
Costs and Cost Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Hawkins, M. L., Bailey, R. L., & Carraway, R. P. (1990). Is diagnostic peritoneal lavage for blunt trauma obsolete? American Surgeon, 56(2), 96-99.

Is diagnostic peritoneal lavage for blunt trauma obsolete? / Hawkins, M. L.; Bailey, R. L.; Carraway, R. P.

In: American Surgeon, Vol. 56, No. 2, 01.01.1990, p. 96-99.

Research output: Contribution to journalArticle

Hawkins, ML, Bailey, RL & Carraway, RP 1990, 'Is diagnostic peritoneal lavage for blunt trauma obsolete?', American Surgeon, vol. 56, no. 2, pp. 96-99.
Hawkins ML, Bailey RL, Carraway RP. Is diagnostic peritoneal lavage for blunt trauma obsolete? American Surgeon. 1990 Jan 1;56(2):96-99.
Hawkins, M. L. ; Bailey, R. L. ; Carraway, R. P. / Is diagnostic peritoneal lavage for blunt trauma obsolete?. In: American Surgeon. 1990 ; Vol. 56, No. 2. pp. 96-99.
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