Use of urethral catheters for diagnostic peritoneal lavage in blunt abdominal trauma
Background: Diagnostic peritoneal lavage (DPL) has been reported to be a reliable diagnostic tool in assessing the need for liparotomy in blunt abdominal trauma (BAT) with a diagnostic accuracy of more thin 95% when using a peritoneal lavage catheter (PLC). The aim of this study was to determine the diagnostic accuracy of the procedure when small urethral catheters are used as an alternative to the PLC.
Methods: Open diagnostic peritoneal lavage was performed in 115 patients with blunt abdominal trauma in whom clinical assessment for intra-abdominal injury was uninformative. Two-way silicon-coated rubber Foley urethral catheters size 12Fr were used as substitutes for peritoneal lavage catheter. Peritoneal effluent fluid was analysed both macroscopically and by the laboratory estimation of the white and red blood cell counts and amylase levels.
Results: A total of 27 Patients (23.5%) had positive DPL results while three (2.6%) had clinically doubtfur equivocal DPL results. Both groups were subjected to exploratory laparotomy. The rest of cases (73.9%) improved on non-operative (conservative) management. The diagnostic accuracy was 97.6% for macroscopic and 99.1% for laboratory assessment. There were no complications attributed to DPL. There was a significant association between the DPL results and the laparotomy findings <p=0.000). Macroscopic assessment of DPL results was also found to be a reliable diagnostic method in blunt abdominal trauma (p<0.001).
Conclusion: In emergency situations, small urethral catheters size 12Fr are a useful and safe alternative to peritoneal lavage catheters as diagnostic tools in blunt abdominal trauma.
Key words: Urethral catheter, diagnostic, peritoneal lavage, emergency