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East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
ISSN: 1024-297X
EISSN: 1024-297X
Vol. 7, No. 1, 2002, pp. 63-66
Bioline Code: js02011
Full paper language: English
Document type: Research Article
Document available free of charge

East and Central African Journal of Surgery, Vol. 7, No. 1, 2002, pp. 63-66

 en Use of urethral catheters for diagnostic peritoneal lavage in blunt abdominal trauma.
Wangoda R, Upoki AL, Owori F N, Kawooya G M

Abstract

Background: Diagnostic peritoneal lavage (DPL) has been reported to be a reliable diagnostic tool in assessing the need for laparotomy in blunt abdominal trauma (BAT) with a diagnostic accuracy of more than 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 urethra catheters size l2Fr 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 doubtful 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 l2Fr are a useful and safe alternative to peritoneal lavage catheters as diagnostic tools in blunt abdominal trauma.

Keywords
Urethral catheter, diagnostic, peritoneal lavage, emergency

 
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