DPL Still Holds Key Role in Evaluating Blunt and Penetrating Trauma

In hemodynamically unstable patients, positive DPL always predicted intra-abdominal injury that required surgery.

Diagnostic peritoneal lavage (DPL), developed in 1964 by Harlan Root, has steadily lost favor because of the advent of computed tomography and the Focused Assessment with Sonography for Trauma (FAST). These authors reviewed the performance of DPL in initial evaluations of blunt abdominal trauma and torso stab wounds at a single level I trauma center in Denver from 1996 through 2006. A positive DPL was defined as aspiration of >10 mL gross blood or any of the following findings in the lavage fluid: white blood cell count >500/µL, amylase >19 IU/L, alkaline phosphatase >2 IU/L, total bilirubin >0.3 mg/dL, or red blood cell count >100,000/µL (or 10,000/µL for left upper quadrant stab wounds, indicating possible diaphragmatic injury). DPL resul…

Reviewing Author

John A. Marx, MD, FAAEM