Emergency Medicine Book

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Diagnostic Peritoneal Lavage

Aka: Diagnostic Peritoneal Lavage
  1. Indications
    1. See Abdominal Trauma
  2. Contraindications
    1. Do not perform peritoneal lavage when exploratory laparoscopy is clearly indicated
      1. Do not delay inevitable definitive evaluation for tests that will not modify management
    2. CT Abdomen and Pelvis is preferred in most cases
    3. Multiple prior abdominal surgeries
    4. Cirrhosis
    5. Coagulopathy
    6. Morbid Obesity
  3. Interpretation: Positive Test
    1. Initial aspirate with gross blood >5 ml
    2. Unspun aspirate with >100k RBC or >500 WBC/mm3
    3. Aspirated lavage fluid with enteric contents (feces, bile, food)
    4. Lavage fluid exits the Foley Catheter or Chest Tube

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