What is peritoneal lavage?
Peritoneal lavage is a bedside procedure for evaluating bleeding in the abdominal cavity or a ruptured organ. In this procedure, a needle connected to a catheter, a tube-like structure, is inserted into your abdominal cavity. It is commonly known as diagnostic peritoneal lavage (DPL).
Diagnostic peritoneal lavage is used to evaluate the extent of abdominal trauma caused by accidents, e.g., in motor vehicle accidents. However, with the advent of computerized tomography (CT scan), the use of DPL to detect bleeding in the abdominal cavity has decreased considerably.
What is peritoneal lavage used for?
Diagnostic peritoneal lavage is used in unstable patients who have suffered severe physical trauma (unstable means unconscious with abnormal heart rate, blood pressure, and respiratory rate). It is an emergency diagnostic procedure that is preferred over the CT scan in these patients because a delay encountered while performing the CT scan might endanger life.
Being a bedside procedure, diagnostic peritoneal lavage is feasible in patients whose life is at stake— where every minute counts to save a life.
The conditions where peritoneal lavage is used include:
- Blunt abdominal injury: An injury that occurs due to blunt trauma to the abdomen, e.g., due to falling from a tall height to the ground, a heavy blow with a fist or with any blunt object to the abdomen, or banging the abdomen on the steering wheel during motor vehicle accidents.
- Penetrating abdominal injury: An injury that occurs when sharp instruments, weapons (stab injury), or gunshots pierce the abdomen.
- To avoid laparotomy surgery (making a large cut to open the abdomen): In many cases, the decision of when to perform a laparotomy surgery becomes quite tricky in patients who have suffered extensive trauma from an accident. Based on the findings of the diagnostic
peritoneal lavage, it becomes clear to the surgeons whether to perform surgery on the patients or try an alternative treatment.
What makes you unfit for peritoneal lavage?
The conditions that make you unfit for diagnostic peritoneal lavage include:
How is peritoneal lavage performed?
- You will be rested on your back (supine position).
- A catheter (a rubber tube) may be inserted in your urethra and nasogastric tube (feeding tube) into your nose to avoid injury to your bladder and stomach.
- A sterile solution will be applied to the abdomen where the incision is planned.
- A local anesthetic solution will be injected to numb the area of operation.
- An incision will be made 2 cm below the umbilicus or belly button.
- A catheter with a needle will be inserted through this incision.
- The fluid will be drawn (aspiration of fluid) through the needle to check for the presence of blood. This will be done in two steps.
- If 10 mL or more of blood is aspirated, the procedure will be stopped.
- If little or no blood is detected, the doctor will perform a lavage (washing) of the abdominal cavity with a normal saline solution. A small sample of the abdominal fluid will be collected and sent to the laboratory for investigation.
What are the complications of peritoneal lavage?
- Local or systemic infection
- Hematoma (collection of blood)
SLIDESHOW
Appendicitis: Symptoms, Signs, Causes, Appendectomy in Detail See SlideshowHealth Solutions From Our Sponsors
Diagnostic Peritoneal Lavage. Available at: https://emedicine.medscape.com/article/82888-overview
Top How Is Peritoneal Lavage Performed Related Articles
Abdominal Adhesions (Scar Tissue)
Abdominal adhesions (scar tissue) bands of scar tissue that form between abdominal organs and tissues. Symptoms of abdominal adhesions are pelvic or abdominal pain. Abdominal adhesions on the intestines can cause bowel obstruction, which is a medical emergency. Treatment for abdominal adhesions is generally surgery to cut the adhesions away from the internal tissues and organs. There is no way to prevent abdominal adhesions.
Abdominal Aortic Aneurysm
Abdominal aortic aneurysm is a ballooning or widening of the main artery (the aorta) as it courses down through the abdomen. Most abdominal aortic aneurysms produce no symptoms. Treatment may include observation or surgical repair.
Abdominal Migraines in Children and Adults
Abdominal migraine in adults and children is a variant of migraine headaches. Abdominal migraine in children generally occurs in children who have a family history of migraines. Causes of abdominal migraine is not known. Symptoms of abdominal migraine include acute, severe, midline abdominal pain, nausea, vomiting, paleness, and inability to eat. Abdominal migraine is diagnosed through patient history, family history, and ruling out other medical causes. Treatment of abdominal migraine include tricyclic antidepressants and triptans.
What Causes Abdominal Pain?
Abdominal pain can have many causes that range from mild to severe. Some of these causes include bloating, gas, colitis, endometriosis, food poisoning, GERD, IBS (irritable bowel syndrome), ovarian cysts, abdominal adhesions, diverticulitis, Crohn's disease, ulcerative colitis, gallbladder disease, liver disease, and cancers. Signs and symptoms of the more serious causes include dehydration, bloody or black tarry stools, severe abdominal pain, pain with no urination or painful urination. Treatment for abdominal pain depends upon the cause.
What's Causing Your Abdominal Pain?
In general, abdominal pain, which may be in the lower left or right of your abdomen, is a symptom of many possible conditions including appendicitis, ulcers, irritable bowel syndrome, indigestion, and others. It may accompany constipation, diarrhea, vomiting, and other symptoms. Find out the potential causes of pain in the abdomen and learn when you should see a doctor.
Ovarian, Fallopian Tube, Primary Peritoneal Cancer Prevention
Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer.
Different ways to prevent cancer are being studied, including:
- Changing lifestyle or eating habits.
- Avoiding things known to cause cancer.
- Taking medicines to treat a precancerous condition or to keep cancer from starting.
What Is Abdominal Wall Reconstruction?
Abdominal wall reconstruction is a surgery involving the reconstruction of the abdominal wall in order to restore anatomy and function. For example, abdominal wall reconstruction can be used to repair a hernia of the front of the abdomen. The abdominal wall (or the belly) protects the abdominal organs, such as the stomach, the liver and others and helps maintain posture while supporting the spine. The abdominal wall also assists in important body functions such as coughing, urination, and defecation.