• Shahriar Hashemzadeh, Kamran Mameghani, Rohollah F Fouladi, and Elnaz Ansari.
• Department of Thoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.
• Ulus Travma Acil Cer. 2012 Jan 1;18(1):37-42.

BackgroundManaging hemodynamically stable patients with thoracoabdominal stab wounds is still under dispute. This study aimed at discussing cut-off points of red blood cell (RBC) count in diagnostic peritoneal lavage (DPL) effluent in these patients.MethodsThree hundred and eighty-eight patients with thoracoabdominal stab wounds and hemodynamically stable status were enrolled. In cases without a clear indication of laparotomy, the peritoneal cavity was washed out with 1000 ml of normal saline and the effluent fluid was analyzed for RBC count. RBC counts of >100,000/mm3 in abdominal wounds and of >10,000/mm3 in lower chest wounds were considered as indications for exploratory laparotomy (conventional approach). New cut-off points for RBC count were calculated in backward analysis.ResultsSensitivity and specificity of the conventional approach were 90% and 84%, respectively. RBC counts >15,000/mm3 in abdominal wounds and >25,000/mm3 in lower chest wounds were the best cut-off points in distinguishing patients with and without need of operation, with a sensitivity and specificity of 94% and 96%, respectively.ConclusionNew cut-off points of RBC count in DPL effluent may promote management of patients with thoracoabdominal stab wounds and no obvious indication for operation.

24 keywords...

hide…