2024-03-29T00:53:58Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00016865
2022-12-15T03:48:11Z
453:456
471:537:538:1112
Diagnostic Peritoneal Lavage for Blunt Abdominal Trauma : A Single-Center Experience
鈍的腹部外傷における診断的腹腔洗浄の経験
鈍的腹部外傷における診断的腹腔洗浄の経験
広瀬, 保夫
106932
本多, 拓
106933
斎藤, 英樹
106934
片柳, 憲雄
106935
山本, 睦生
106936
桑山, 哲治
106937
藍沢, 修
106938
丸田, 宥吉
106939
diagnostic peritoneal lavage (DPL)
blunt abdominal trauma
traumatic intestinal injury
診断的腹腔洗浄
鈍的腹部外傷
外傷性腸管損傷
The early diagnosis of hollow visceral injury in blunt abdominal trauma is difficult, especially in multiple injuries and in comatose patients, despite the recent progress of radiographic diagnostic procedures. We evaluated the accuracy of diagnostic peritoneal lavage (DPL), especially for diagnosis of intestinal injury, using the diagnostic criteria proposed by Otomo Y et. al. in 1989. This diagnostic criteria is characterized from the supplementary criteria:"WBC ≧ RBC/150 (if hemoperitoneum positive), amylase or alkaline phosphatase ≧ RBC/10,000" added to the conventional DPL criteria:"WBC ≧ 500/mm^3" for intestinal injury. From April 1996 to December 1996, 37 cases of blunt abdominal trauma were admitted to our emergency medical center, including multiple trauma complicated with abdominal injuries. We did not perform DPL if the indication for laparotomy was obvious in clinical and radiographic findings. We performed DPL in 15 patients based on the following criteria:1) patients with equivocal findings on the abdominal physical examination ultrasonography and/or computed tomography, 2) patients who could not have their abdominal examination due to an altered mental state, or patients receiving sedative drugs. Ten patients were judged negative for an intestinal jnjury by DPL, and the absence of an intestinal injury were confirmed in 9 patients, excluding 1 patient who immediately died. If they were judged by conventional DPL criteria, false positive occured in 4 patients. Five patients were judged as having positive intestinal injuries by DPL, all patients of whom had intestinal injuries in laparotomy. Only in alkaline phosphatase, false negative occurred in 3 patients. Data in this series suggest that the DPL criteria proposed by Otomo Y et. al. is more accurate to diagnose intestinal injury than the conventional criteria, DPL is a useful method as a complementary examination in cases with equivocal clinical, radiographic and sonographic findings in evaluation of blunt abdominal trauma.
departmental bulletin paper
新潟医学会
1998-01
application/pdf
新潟医学会雑誌
1
112
29
36
新潟医学会雑誌
AN00182415
00290440
https://niigata-u.repo.nii.ac.jp/record/16865/files/112(1)_29-36.pdf
jpn