Diagnostic peritoneal lavage - series

Indication

Blunt trauma to the abdomen is a major component of traumatic injury and can be deadly. Blunt trauma can occur during falls, motor vehicle accidents, or severe blows to the abdomen.

Incision

Often it is difficult to determine if an intra-abdominal injury has occurred in a blunt trauma victim. In many cases, the decision about when to perform an exploratory laparotomy surgery is not straightforward. One procedure used to determine whether blunt trauma victims require surgery is diagnostic peritoneal lavage (DPL). DPL helps determine whether an intra-abdominal injury exists and whether sugery is required. Using local anesthesia, the surgeon makes a small incision in the abdomen just below the umbilicus.

Procedure, part 1

A catheter is introduced through the incision into the abdomen. Saline is infused into the abdomen through the catheter, and then removed. If blood is present in the saline after removal, it is highly probable that there is a serious intra-abmoninal injury.

Procedure, part 2

CT scans are also used to detect intra-abdominal injury in trauma patients and are a valuable adjunct to DPL. The combination of DPL and CT scan allows surgeons to minimize the incidence of unnecessary laparotomy in trauma patients.