• Suvit Sriussadaporn, Rattaplee Pak-art, Mongkol Pattaratiwanon, Arruk Phadungwidthayakorn, Yongsun Wongwiwatseree, and Taveesak Labchitkusol.
• Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
• Eur J Surg. 2002 Jan 1;168(8-9):490-3.

ObjectiveTo evaluate patients with stab wounds of the anterior abdomen with diagnostic peritoneal lavage (DPL), by using initial aspiration of gross blood from the lavage catheter of more than 10 ml or red blood cell (RBC) count in the lavage fluid of more than 10,000/mm3 as criteria for exploratory laparotomy.DesignProspective study.SettingUniversity hospital, Thailand.Patients40 patients who had stab wounds of the anterior abdomen penetrating through the peritoneum but had no obvious indications for immediate exploratory laparotomy.InterventionsDiagnostic peritoneal lavage (DPL), exploratory laparotomy.Main Outcome MeasuresSensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of positive DPL as an indication for exploratory laparotomy.ResultsIn 27 patients (68%) the DPL was positive and in 13 (33%) it was negative. In 18 patients (67%) the initial aspiration of gross blood was more than 10 ml and in 9 (33%) the RBC count in lavage fluid was more than 10,000/mm3. These 27 patients had exploratory laparotomies, 2 of which were negative. All 13 patients who had negative DPL were observed and discharged home uneventfully. The sensitivity of DPL for positive laparotomy was 100%, the specificity was 87%, the PPV was 93%, the NPV was 100% and the accuracy was 95%. When operative findings of bleeding from the stab wound into the peritoneal cavity were considered as a "negative" laparotomy (n = 7) the sensitivity, the specificity, the PPV, the NPV and the accuracy became 100%, 59%, 67%, 100%, and 78%, respectively.ConclusionThe use of DPL in patients with stab wounds of the anterior abdomen, using initial aspiration of gross blood from the lavage catheter of more than 10 ml or RBC count in the lavage fluid of more than 10,000/mm3 as positive criteria for exploratory laparotomy, is safe and practical.

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