"DETECTION OF INTRA-ABDOMINAL INJURY IN TRAUMA PATIENTS: OUR EXPERIENCE WITH DIAGNOSTIC PERITONEAL LAVAGE"

Abstract

Diagnostic peritoneal lavage (DPL) is considered by many as the most important investigation for the early detection of intraperitoneal injury. The aim of this study is to assess the accuracy of DPL as a diagnostic method in evaluating abdominal trauma. A prospectively maintained database of all DPLs performed in the past 36 months at Sina Hospital was analyzed. Information relative to the type of injury, indication for DPL, DPL and laparatomy results were analyzed in order to evaluate the accuracy, sensitivity and specificity of DPL. Over a 36-month period, 111 (13.9%) DPLs were performed for 800 patients with abdominal trauma at Sina Hospital. Fifty-five (49.5%) patients had negative and 56 (50.5%) patients had positive DPL. Among negative results, laparatomies were performed for 5 (9.1%) patients. Among positive results, 47 patients had organ injuries at laparatomy and 6 (11.3%) did not have any organ injuries (false positive). The overall accuracy, sensitivity and specificity of DPL were 87%, 90% and 85%, respectively, that were comparable to the other reports (p<0.05). DPL correctly identified the presence or absence of organ injuries in 87% of the patients (positive predictive value =84%, negative predictive value=91%).