![]() ![]() A cell count ratio >/=1 predicted hollow organ perforation with aspecificity of 97% and a sensitivity of 100%. The cell count ratio was defined as the ratio between white blood cell count and red blood cell count in the lavage fluid, divided by the ratio of the same parameters in the peripheral blood. In a report on the utility of DPL, Fang et al described the importance of the cell count ratio. The presence of vegetable matter is also suggestive. Solid Organ Injuries Damage to solid organs such as the liver can cause severe internal bleeding Blood in the peritoneal cavity causes peritonitis When patients injure solid organs, the symptoms of shock may overshadow those from peritonitisĮD Ultrasound Not an echocardiogram Learning curve and operator-dependent Four quadrant evaluation for fluid In common use Useful in conjunction with CT and to triage unstable patientĬT Scan Hemodynamically stable patients Visualizes retroperitoneum Duodenum, pancreas, kidneys Cystogram Poor sensitivity for bowel injury Seat belt injury associated with bowel injury L-2 to L-4 fracture Peri-umbilical abdominal contusionĭiagnostic Peritoneal Lavage Sensitivities of 98% Specificity of 80% Does not discriminate well Does not evaluate retroperitoneumĬriteria for Interpretation of Lavage Positive Aspiration > 10 ml non-clotting blood Lavage fluid comes out Foley catheter or chest tube Grossly bloody lavage return RBC > 100,000/mm 3 WBC > 500/mm3 Amylase > 175 K.U./dl Presence of bile, bacteria and/or particulate matterĬriteria for Interpretation of Lavage Indeterminate Aspiration 500/mm) in the effluent is highly suggestive of bowel injury. Hollow Organ Injuries When hollow organs rupture, their highly irritating and infectious contents spill into the peritoneal cavity, producing a painful inflammatory reaction called peritonitis Hollow and Solid Organs Hollow organs include: stomach intestines gallbladder bladder Solid organs include: liver spleen kidneys ![]() Closed Injuries Closed injuries are caused by compression trauma associated with deceleration forces and include: Contusions Ruptures Lacerations shear injuries ![]() Closed Injuries Open injuries are caused by sharp or high velocity objects that create an opening between the peritoneal cavity and the outside of the body Presentation on theme: "Department of Surgery Ruijin Clinical Medical College Shanghai Jiao Tong University."- Presentation transcript:ĭepartment of Surgery Ruijin Clinical Medical College Shanghai Jiao Tong University ![]()
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