| 词条 | Diagnostic peritoneal lavage |
| 释义 |
Name = Diagnostic peritoneal lavage | Image = | Caption = | ICD10 = | ICD9 = {{ICD9proc|54.25}} | MeshID = D010533 | OPS301 = | OtherCodes = |}}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.[1] IndicationsThis procedure is performed when intra-abdominal bleeding (hemoperitoneum), usually secondary to trauma, is suspected.[2] In a hemodynamically unstable patient with high-risk mechanism of injury, peritoneal lavage is a means of rapidly diagnosing intra-abdominal injury requiring laparotomy, but has largely been replaced in trauma care by the use of a focused assessment with sonography for trauma (FAST scan) due to its repeatability, non-invasiveness and non-interference with subsequent computed tomography (CT scan). 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. Magnetic resonance imaging is extremely accurate for the anatomic definition of structural injury, but logistics limit its practical application in acute abdominal trauma.[3][4] The procedure was first described in 1965 by Hauser Root.[5][6] ProcedureAfter the application of local anesthesia, a vertical skin incision is made one third of the distance from the umbilicus to the pubic symphysis. The linea alba is divided and the peritoneum entered after it has been picked up to prevent bowel perforation. A catheter is inserted towards the pelvis and aspiration of material attempted using a syringe. If no blood is aspirated, 1 litre of warm 0.9% saline is infused and after a few (usually 5) minutes this is drained and sent for analysis.[7] Interpretation of resultsIf any of the following are found then the DPL is positive and operative exploration is warranted:[8]
See also
References1. ^Rosen 2009, p. 22 2. ^Rosen 2009, p. 422-4 3. ^{{cite book|vauthors = Tintinalli JE, Kelen GD, Stapczynski JS| title = Emergency Medicine: A Comprehensive Study Guide, ed 6 | publisher = McGraw-Hill | year = 2004 | pages = 1615–1616}} 4. ^{{cite book|vauthors = ((Townsed CM Jr)), Beauchamp RD, Evers BM| title = Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, ed 18 | publisher = Saunders | year = 2008 | pages = 502–504|display-authors=etal}} 5. ^{{cite web | url=http://emedicine.medscape.com/article/82888-overview | title=Diagnostic Peritoneal Lavage | publisher=Medscape | date=June 18, 2012 | accessdate=December 31, 2012 | author=Jagminas, Liudvikas}} 6. ^{{cite journal | vauthors = Root H, Hauser C, McKinley C, Lafave J, Mendiola R | title = Diagnostic peritoneal lavage. | journal = Surgery | volume = 57 | issue = | pages = 633–7 | year = 1965 | pmid = 14295771}} 7. ^{{cite video | url=https://www.youtube.com/watch?v=O9BZamRlXVA | title=Diagnostic Peritoneal Lavage (DPL) | publisher="The Division of Trauma/Surgical Critical Care/Burns is part of the Department of Surgery, UC San Diego Health System | date=July 17, 2012 | people=Kim, Dennis(Narrator) | location=San Diego | time=4:00}} 8. ^{{cite book |author=Andrew B., MD Peitzman |author2=Andrew B. Peitzman |author3=Michael, MD Sabom |author4=Donald M., MD Yearly |author5=Timothy C., MD Fabian |title=The trauma manual |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2002 |pages= |isbn=0-7817-2641-7 |oclc= |doi= |accessdate=}} Bibliography
External links
2 : Digestive system procedures|Trauma surgery |
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