Alkaline Phosphatase Levels in Diagnostic Peritoneal Lavage Fluid as a Predictor of Hollow Visceral Injury

Validating the Western Trauma Association Algorithm for Managing Patients With Anterior Abdominal Stab Wounds: A Western Trauma Association Multicenter Trial

“…Recognizing the problem of equivocal DPL results, measurements of amylase and alkaline phosphatase have been suggested to improve the SENS of DPL. 21,36,37 These results, like the WBC count, are somewhat dependent on the timing of DPL; furthermore, the enzymes may not reliably diagnose colon injury. 34,36,37 Unfortunately, in this series, enzyme levels were no better than WBC counts at identifying bowel injuries.…”

“…21,36,37 These results, like the WBC count, are somewhat dependent on the timing of DPL; furthermore, the enzymes may not reliably diagnose colon injury. 34,36,37 Unfortunately, in this series, enzyme levels were no better than WBC counts at identifying bowel injuries. In contrast to the previous WTA trial, the issue with DPL in this series was not false (ϩ) studies, but rather LAP based on DPL when results were below the usual thresholds.…”

Management of Patients With Anterior Abdominal Stab Wounds: A Western Trauma Association Multicenter Trial

“…Recognizing the problem of equivocal DPL results, measurement of amylase and alkaline phosphatase have been suggested to improve the SENS of DPL. 20,33,34 These results, like the WBC count, are somewhat dependent on the timing of DPL; furthermore, the enzymes may not reliably diagnose colon injury. 31,33,34 Unfortunately, in this series, enzyme levels were no better than WBC counts at identifying bowel injuries.…”

The Effectiveness of Focused Assessment With Sonography for Trauma in Evaluating Blunt Abdominal Trauma With a Seatbelt Mark Sign

“…DPL has an overall sensitivity of 98%, specificity of 98%, and diagnostic accuracy close to 100% [10]. Criteria specifically designed to help aid in the diagnosis of hollow viscus injuries utilizing fluid measurements of amylase, alkaline phosphatase, and white blood cell to red blood cell ratios have shown high diagnostic sensitivity and specificity [11,12]. DPL is an invasive exam, does not identify the cause of hemoperitoneum, and a positive study may lead to a nontherapeutic exploratory laparotomy [13].…”