ICU management of patients with suspected positive findings of diagnostic peritoneal lavage following blunt abdominal trauma / 中华创伤杂志(英文版)

ABSTRACT

<p><b>OBJECTIVE</b>To explore the management for blunt abdominal trauma victims with probable positive diagnostic peritoneal lavage (DPL) findings.</p><p><b>METHODS</b>Data of 76 patients with probable positive DPL findings accepted to ICU in previous 10 years were reviewed. After admission, the patients were evaluated in a settled time according to the protocols of Advanced Trauma Life Support (ATLS). Vital signs were continuously monitored and DPL, ultrasound and/or CT scan were repeated when necessary.</p><p><b>RESULTS</b>Eighteen (24%) of 76 patients presented positive DPL findings after repeated DPL. Surgical findings confirmed 7 cases of spleen rupture, 3 hepatorrhexis (infra-Glisson capsule), 4 intestinal perforation, 2 gastric perforation, 1 colon perforation and 1 injured mesentery.</p><p><b>CONCLUSIONS</b>Patients with probable positive DPL findings were admitted to ICU with vital signs continuously monitored. Repeated DPL with supplemental ultrasound and/or CT scan can work together to increase the sensitivity and accuracy of the diagnosis, reduce the rate of exploratory laparotomy, ensure patients' safety and provide a reliable basis for therapeutic operations.</p>