诊断性腹腔灌洗.pdfVIP

Diagnostic Peritoneal Lavage 69 Latha Ganti 69.1 Indications (Table 69.1 ) • Inability to perform FAST exam due to lack of equipment or operator • Hemodynamically unstable patient in whom FAST exam is negative or equivocal Table 69.1 Comparison parameters for DPL, FAST, and CT [ 1 ] DPL FAST CT Speed 10–15 min Fastest: 5 min Variable Repeatable Yes, but rarely done Yes, and frequently done Yes, but not done often Cost $ $$ $$$ Invasive Yes No No Mobile Yes Yes No Advantages Most sensitive for mesenteric and Highest specifi city Highly accurate but can be hampered hollow viscus injuries by patient movement Disadvantages Misses retroperitoneal and Hampered by subcutaneous or Misses diaphragm, small bowel, and diaphragm injuries intra-abdominal air, obesity, and pelvic pancreatic injuries fractures Small but signifi cant risk of radiation- Signifi cant false-negative rate associated