The effect of time interval from index trauma on results of diagnostic peritoneal lavage in animal samples

Abstract

Diagnostic peritoneal lavage (DPL) is an invasive and highly sensitive diagnostic tool to detect abdominal trauma. Despite recent trend to use non-invasive tools such as FAST and CT scan to detect these injuries, DPL has its place in trauma management particularly for hollow visceral injury. Using RBC count to detect intestinal injuries has had low accuracy rate. WBC count, amylase, and alkaline phophatase (ALP) levels have been useful in this regard but with some controversies. The study was carried out on 90 rats, divided to 3 groups (30 rats each), and every group was subdivided randomly to 15 case and 15 control rats. For case rats, perforations were done in the small intestine using a needle. In all rats a catheter was placed in the peritoneum. Lavage of the peritoneum was done through the catheter 1, 6, and 12 hours after the trauma for first, second, and third group, respectively. WBC count was not different between case and control rats 1 hour post-injury, but was increased 6 and 12 hours after perforation in case rats. Amylase and ALP levels were higher in case rats in all of three groups compared to control rats. Further human studies must be done to clarify the normal and abnormal values of WBC count, amylase, and ALP levels of DPL analysis. Furthermore, the effect of time interval on these parameters must be appreciated and taken into account in interpreting the results of DPL to detect abdominal injuries as soon as possible.