Diagnostic peritoneal lavage

Diagnostic Peritoneal Lavage (DPL) is a medical procedure primarily used in the assessment of blunt abdominal trauma. It is a rapid, minimally invasive procedure that can help determine whether a patient requires emergency surgery.

Procedure

The procedure involves the insertion of a catheter into the peritoneal cavity, the space within the abdomen that contains the stomach, liver, and other abdominal organs. A sterile solution is then infused into the cavity and subsequently withdrawn. The fluid is then examined for the presence of blood, bile, bowel content, or urine, which would indicate injury to an abdominal organ.

Indications

DPL is primarily indicated in patients with blunt abdominal trauma who are hemodynamically unstable, have equivocal physical findings, or have sustained multiple traumas. It can also be used in patients with penetrating abdominal trauma where the trajectory of the injury is unclear.

Limitations

While DPL is a sensitive test for intra-abdominal injury, it has several limitations. It cannot differentiate between injuries that require surgical intervention and those that can be managed non-operatively. It also cannot identify the specific organ injured. Furthermore, it is an invasive procedure with potential complications such as infection and injury to abdominal organs.

History

DPL was first described in the 1960s and was widely used in the assessment of abdominal trauma. However, with the advent of Computed Tomography (CT) and Focused Assessment with Sonography for Trauma (FAST), the use of DPL has declined.

See also

• Blunt abdominal trauma
• Penetrating abdominal trauma
• Computed Tomography
• Focused Assessment with Sonography for Trauma