Inaccuracy of Diagnostic Peritoneal Lavage in Penetrating Colonic Trauma

Obeid, Farouck N.; Sorensen, Victor J.; Vincent, G.; Horst, H. Mathilda; Vij, Deepak; Bivins, Brack A.

doi:10.1001/archsurg.1984.01390200026006

Cited by 6 publications

(1 citation statement)

References 7 publications

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“…It is sensitive for the presence of intraperitoneal blood, but this result in itself does not predict a therapeutic laparotomy, and thereby decreases the specificity of the test (Inaba and Demetriades, 2007). The false-negative rate of diagnostic peritoneal lavage for the detection of hollow viscus injuries is around 30% (Obeid et al., 1984).…”

Section: Investigation Of Patients Being Considered For Non-operativementioning

confidence: 99%

The principles of non-operative management of penetrating abdominal injury

Wohlgemut

Jansen

2013

Trauma

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The selective non-operative management of penetrating abdominal injury is gaining increasing acceptance. Recognition of the morbidity, mortality, and cost associated with non-therapeutic exploration has provided the impetus for selective management. This review describes the principles of, and evidence for, this strategy. Selective management is widely accepted for the treatment of stab wounds, but the selective management of ballistic injuries, particularly in the military setting, remains contentious. As a result, there are marked variations in the application of this practice. Computed tomography is a prerequisite for the selective management of ballistic injuries, and possibly also stab wounds. Failure of non-operative management, following stab wounds or gunshot wounds, is invariably apparent within 24 hours.

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Section: Investigation Of Patients Being Considered For Non-operativementioning

confidence: 99%

The principles of non-operative management of penetrating abdominal injury

Wohlgemut

Jansen

2013

Trauma

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Protein electrophoresis of diagnostic peritoneal lavage in penetrating abdominal trauma: A marker of significant injury

McDonald

Muckart

1989

Journal of British Surgery

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Protein electrophoresis of diagnostic peritoneal lavage fluid has been shown in experimental work to be a marker of hollow viscus injury. In order to ascertain the value of this investigation in penetrating abdominal trauma, we conducted a prospective study, over a 4-month period, involving 35 patients with stab wounds to the abdomen whose initial clinical examination was equivocal. The results of electrophoresis were compared with the standard quantitative criteria for diagnostic lavage and the operative findings. Protein electrophoresis was found to be a more sensitive and specific marker of significant intra-abdominal injury than the standard quantitative criteria.

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Evaluation of diagnostic peritoneal lavage in suspected penetrating abdominal stab wounds using a dipstick technique

Muckart

McDonald

1991

Journal of British Surgery

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The total protein content (g/l) and white blood cell count (cells/mm3) diagnostic peritoneal lavage was assessed using a urine dipstick in 46 patients with suspected penetrating abdominal stab wounds and equivocal physical examination. Those patients with a protein content greater than or equal to 1 g/l and white blood cell count of greater than 500 cells/mm3 were submitted to laparotomy while those with lower values underwent observation and repeat physical examination. In all, 26 patients had a positive lavage and significant injuries were found in 23 of these. Of 18 patients with a negative lavage, 17 were managed successfully without operation while one patient died from complications related to central venous catheterization. In two patients the lavage results were equivocal. One underwent a negative laparotomy and the remaining patient recovered uneventfully. The test has a 100 per cent sensitivity and 86 per cent specificity and provides an accurate, cheap, and rapid means of diagnosis of intra-abdominal injury in penetrating trauma.

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Inaccuracy of Diagnostic Peritoneal Lavage in Penetrating Colonic Trauma

Cited by 6 publications

References 7 publications

The principles of non-operative management of penetrating abdominal injury

The principles of non-operative management of penetrating abdominal injury

Protein electrophoresis of diagnostic peritoneal lavage in penetrating abdominal trauma: A marker of significant injury

Evaluation of diagnostic peritoneal lavage in suspected penetrating abdominal stab wounds using a dipstick technique

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