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PubMed1979

[Drainage and lavage in abdominal trauma].

Peritoneal lavage is a reliable procedure in diagnosis of posttraumatic intra-abdominal bleeding. The method is extremely sensitive. If the return is found weakly positive, the lavage catheter should be left in position until the situation is cleared. Insufflation of air through the catheter may be used in diagnosis of a ruptured diaphragm. In the first days after trauma, peritoneal lavage may as well be helpful to detect secondary bleeding (for example in delayed rupture of the spleen) in unconscious patients or during mechanical ventilation. Postoperative drainage of the abdomen, too, is of considerable diagnostic value: for assessment of postoperative bleeding and in diagnosis of delayed intestinal perforation or insufficiency of a sutured bowel lesion. In pancreatic trauma, adequate drainage of pancreatic secretions prevents arterial arrosion or the formation of a pseudocyst. Determination of amylase in the drained fluid guides the further therapy: duration of total parenteral nutrition, suppression of pancreatic activity by drugs, removal o the drains. Tactics in draining the abdominal cavity after trauma should take into consideration an optimal removal of blood and secretions as well as the mentioned diagnostic value. In specially indicated cases the drainage system also should allow to perform peritoneal dialysis.

Abdominal Injuries↗