Diagnostic peritoneal lavage.
From the preceding review, it can be seen that diagnostic peritoneal lavage is a safe, reliable means of evaluating the various acute conditions of the abdomen. Patients who have sustained, blunt trauma of the abdomen, particularly with associated injuries, are prime candidates for the procedure. Children who have sustained injuries, either suspected abdominal injuries or multiple trauma, should be included. Other groups include paraplegic patients with possible abdominal disease and patients with findings which are suggestive of an acute condition of the abdomen but an uncertain diagnosis. Relative contraindications for peritoneal lavage include a distended abdomen, a history of previous surgical procedures of the abdomen and gravid uterus. Peritoneal lavage may be performed upon these patients but with modifications of technique. Patients for whom the diagnosis is certain and those patients upon whom exploration is planned are not candidates for lavage. Peritoneal lavage has been shown to be an effective adjunct in the evaluation of the abdomen in a wide variety of conditions. Its use has decreased the rate of unnecessary laparotomy both in patients with blunt trauma to the abdomen and in those with nontraumatic, acute disease of the abdomen. It can be used to arrive at an early decision for operative and nonoperative therapy and thereby reduce morbidity and mortality in patients with abdominal disease.