[
Abstract]
[
Full Text PDF] （in Japanese / 720KB）
[Members Only And Two Factor Auth.] J.Jpn. Surg. Soc.. 90(12): 2008-2014, 1989
Original article
USEFULNESS AND PROBLEMS OF PERITONEAL TAP＆LAVAGE ON THE DIAGNOSIS OF BLUNT ABDOMINAL TRAUMA
ーEFFICACY FOR DIAGNOSIS OF INTESTINAL INJURYー
It is difficult to diagnose blunt intestinal injury, despite of the progress of radiological diagnostic procedures, if patient has an altered mental status or an associated injury which hampers abdominal physical findings. So we conducted a prostective study about usefulness of peritoneal tap and lavage on the diagnosis of blunt abdominal injury. From September 1987 to August 1988 we performed peritoneal lavage in 36 patients and investigated the diagnostic accuracy of this method for detecting each organ injuries. We adopted conventional criteria “RBC≧100000/mm
3, WBC≧500/mm
3" and also employed new supplementary criteria“ WBC≧RBC/150 (if RBC/is positive), Amylase or Alkaline phosphatase≧ RBC/10000, GOT or GPT≧RBC/40000". The diagnostic accuracy rates were 1) intestinal injury: WBC-sensitivdty (se) 75%, Specificity (sp) 100% 2) small intestinal injury; AMY-se 100%, sp 90%, Alp-se 100%, sp 100% 3) hepatic injury; GOT or GPT-se 100%, sp 91%. These satisfactory results can be obtained by employment of the new supplementary criteria.
Peritoneal tap and lavage is easy to perform but is sometimes found to have poor fluid return. So we recommend to adopt the authentic method of peritoneal lavage.
We concluded from this study that if these new supplementary criteria are employed peritoneal lavage can be useful to diagnose blunt intestinal injury.
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