• Tomoi Sato, Yasuo Hirose, Hideki Saito, Mutsuo Yamamoto, Norio Katayanagi, Tetsuya Otani, Shirou Kuwabara, Kenichiro Hirano, Hidenori Kinoshita, Toshiharu Tanaka, Yoshihiko Yamazaki, Osamu Aizawa, and Katsuyoshi Hatakeyama.
• Department of Surgery, Niigata City General Hospital, Japan.
• Surg. Today. 2005 Jan 1;35(11):935-9.

PurposeTo test the usefulness of diagnostic peritoneal lavage (DPL) for identifying blunt hollow visceral injury with two different sets of criteria or a combination of the two.MethodsFifty victims with physical examinations and/or computed tomography findings equivocal for blunt hollow visceral injury underwent DPL. Whether or not to perform surgery was determined based on Otomo's DPL criteria [lavage white blood cell counts (L-WBC) over lavage red blood cell counts (L-RBC) divided by 150 (L-WBC > or = L-RBC/150) in the presence of hemoperitoneum, or L-WBC over 500/mm(3) (L-WBC > or = 500) in the absence of hemoperitoneum]. The cell count ratio, a comparison of L-WBC, L-RBC, peripheral WBC (P-WBC), and peripheral RBC (P-RBC) [(L-WBC/L-RBC)/(P-WBC/P-RBC) > or = 1] were all calculated retrospectively.ResultsThere were one and two false-positive cases based on Otomo's criteria and the cell count ratio, respectively, with corresponding accuracies of 97.8% and 95.7%, respectively. There were no false-positive or -negative cases according to the combined use of Otomo's criteria and cell count ratio, yielding an accuracy of 100%.ConclusionAlthough each criterion alone is very accurate in predicting the presence of blunt hollow visceral injury, the combined use of the two would further improve the accuracy of the diagnosis and thereby reduce the number of unnecessary celiotomies.

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