When is diagnostic peritoneal lavage indicated?

In a hemodynamically abnormal patient, if FAST is unavailable or results are equivocal, DPL is indicated. In a hemodynamically normal patient, DPL is used when CT and/or FAST are unavailable and the patient has concerning signs/symptoms of abdominal trauma.

When performing a diagnostic peritoneal lavage how much fluid is infused into the abdomen?

One liter of normal saline is infused into the peritoneal cavity via a small catheter and then allowed to flow out of the abdomen by gravity through the same catheter. The results of DPL are considered positive for intra-abdominal injury if there are over 100,000 red blood cells/mL fluid, bacteria, or vegetable matter.

What is DPL in surgery?

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 surgery is required. Using local anesthesia, the surgeon makes a small incision in the abdomen just below the umbilicus.

How is a diagnostic peritoneal lavage done?

Diagnostic peritoneal lavage (DPL) is an invasive emergency procedure used to detect hemoperitoneum and help determine the need for laparotomy following abdominal trauma. A catheter is inserted into the peritoneal cavity, followed by aspiration of intraperitoneal contents, often after their dilution with crystalloid.

How much fluid is needed for a positive FAST?

The volume of free fluid necessary to enable detection with FAST represents a limitation of FAST . Branney and colleagues determined that the mean minimum detectable free-fluid volume during FAST examination in 100 patients undergoing DPL was 619 mL in the Morison pouch (24).

What is the purpose of peritoneal lavage?

What is the purpose of abdominal lavage?

What is a positive FAST exam?

A positive FAST result is defined as the appearance of a dark (“anechoic”) strip in the dependent areas of the peritoneum. In the right upper quadrant this typically appears in Morison’s Pouch (between the liver and kidney). This location is most useful as it is the place where fluid will collect with a supine patient.

When is diagnostic peritoneal lavage indicated? In a hemodynamically abnormal patient, if FAST is unavailable or results are equivocal, DPL is indicated. In a hemodynamically normal patient, DPL is used when CT and/or FAST are unavailable and the patient has concerning signs/symptoms of abdominal trauma. When performing a diagnostic peritoneal lavage how much fluid is…