What is peritoneal lavage?

What is peritoneal lavage?

Peritoneal lavage is a bedside procedure for evaluating bleeding in the abdominal cavity or a ruptured organ. In this procedure, a needle connected to a catheter, a tube-like structure, is inserted into your abdominal cavity. It is commonly known as diagnostic peritoneal lavage (DPL).

What is the purpose of a peritoneal lavage?

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.

When is peritoneal lavage indicated?

DPL is used when FAST and/or CT are not available. 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.

What does peritoneal washing mean in medical terms?

A procedure in which a salt-water solution is used to wash the peritoneal cavity and then is removed to check for cancer cells. The peritoneal cavity is the space in the abdomen that contains the intestines, stomach, and liver.

How long is diagnostic peritoneal lavage?

DPL is 100% accurate for intra-abdominal injury in hemodynamically unstable patients, whereas FAST is positive only 45% of the time. However, DPL also takes 10-15 minutes, and the patient must be stable for the test to be carried out.

When is diagnostic peritoneal lavage positive?

The lavage is positive if there are > 100,000 red blood cells/mL, > 500 white blood cells/mL, or a positive Gram stain test. A negative test does not exclude other solid organ injury, viscus perforation, diaphragmatic tears, or retroperitoneal injury.

How do you collect pelvic wash?

Peritoneal Washings – Pelvic Washings

1. Collect the specimen in a clean, dry screw-top container.
2. Fasten the lid securely to avoid spillage.
3. Do not add any fixative.
4. Refrigerate the specimen if there is a delay in delivery to the laboratory.
5. Complete the Calpath cytology requisition form per the instructions.

Is diagnostic peritoneal lavage still used?

Ultrasound (US) and abdominal computed tomography (CT) have largely replaced the use of diagnostic peritoneal lavage (DPL) in the hemodynamically stable trauma patient. Literature review current through: Sep 2021.

What is peritoneal washing cytology?

Abstract. Peritoneal washing cytology (PWC) is a useful indicator of ovarian surface involvement and peritoneal dissemination by ovarian tumours. It may identify subclinical peritoneal spread and thus provide valuable staging and prognostic information, particularly for non-serous ovarian tumours.

What is a pelvic wash cytology?

Peritoneal washing cytology is a useful indicator of ovarian surface involvement and peritoneal dissemination by ovarian tumors. It may identify subclinical peritoneal spread and thus provide valuable staging and prognostic information [4].

What does it mean to do a diagnostic peritoneal lavage?

Diagnostic peritoneal lavage. Diagnostic peritoneal lavage (DPL) or diagnostic peritoneal aspiration (DPA) is a surgical diagnostic procedure to determine if there is free floating fluid (most often blood) in the abdominal cavity.

How are retractors used for peritoneal lavage?

Retractors can be used to hold back the wound edges and better expose the fascia. 03 The fascia on either side of the wound is then securely grasped using the towel clips and raised up away from the abdominal contents and a small vertical incision (~0.5 cm) is carefully made through the linea alba and fascia, opening the peritoneum.

Can a fast or DPL detect retroperitoneal lavage?

Both FAST and DPL fail to evaluate retroperitoneal and diaphragmatic injuries and poorly identify solid-organ injuries. Abdominopelvic CT requires a hemodynamically stable patient, is costly, and carries a small but significant lifetime risk of malignancy.

Can a abdominal CT be used to diagnose lavage?

Abdominal CT and contrast duodenography may complement lavage in stable patients, but in an unstable or uncooperative persons, these studies are too time-consuming or require ill-advised sedation.