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Article
July 1979

Diagnostic Errors With Peritoneal Lavage in Patients With Pelvic Fractures

Author Affiliations

From the Department of Surgery, University of Kentucky Medical Center, Lexington, KY 40506.

Arch Surg. 1979;114(7):844-846. doi:10.1001/archsurg.1979.01370310086015
Abstract

• Diagnostic peritoneal lavage, considered to be a highly accurate technique for detecting intraperitoneal blood in the trauma patient, may be less reliable in the presence of a pelvic fracture. In a retrospective review of 222 patients with pelvic fractures, 61 patients were found who had had a diagnostic peritoneal lavage performed as part of the initial evaluation of their condition. Twenty-six of these patients had had a negative lavage result. There had been no false-negative results in this group, although six patients required operations for extraperitoneal injuries. Of the 35 patients with a positive lavage result, 10 (29%) were found to have false-positive lavage results with no intraperitoneal source of bleeding. The only deaths in this series occurred in the group requiring operations, eight of 41 (20%). Four of the eight deaths were due to uncontrollable bleeding that resulted from exploration of the retroperitoneal hematoma. These data suggest that a negative lavage result is highly reliable in the patient with a pelvic fracture and should allow management with confidence that there is no severe intraperitoneal injury. Positive lavage results, however, must be interpreted with caution.

(Arch Surg 114:844-846, 1979)

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