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Peritoneal Lavage: Reliability of RBC Count in Patients With Stab Wounds to the Chest

Peritoneal Lavage: Reliability of RBC Count in Patients With Stab Wounds to the Chest Abstract • Two hundred thirteen patients with stab wounds to the lower part of the chest and abdomen were reviewed to determine if a lavage RBC count of 100,000/cu mm was a reasonable figure to permit prompt recognition of injury and to minimize the number of negative operative procedures. There were four (1.9%) false-positive and nine (4.2%) false-negative lavages. Three patients (1.4%) had complications due to delayed operation, including one death (0.47%). Two patients (0.9%) had hollow viscus injuries; neither involved the colon. Three of the nine patients with injuries had cell counts of less than 1,000/cu mm. The negative celiotomy rate was 4.2%. It was concluded that the number of missed injuries, delayed operative procedures, and complications was sufficiently low enough to continue recommending 100,000 RBCs per cubic millimeter as a safe number to use as an indication for operation. (Arch Surg 1984;119:579-584) References 1. Thal ER: Evaluation of peritoneal lavage and local exploration in lower chest and abdominal stab wounds . J Trauma 1977;17:642-648.Crossref 2. Engrav LH, Benjamin CI, Strate RG, et al: Diagnostic peritoneal lavage in blunt abdominal trauma . J Trauma 1975;15:854-859.Crossref 3. Hornyak SW, Shaftan GW: Value of inconclusive lavage in abdominal trauma management . J Trauma 1979; 19:329-333.Crossref 4. Galbraith TA, Oreskovich MR, Heimbach DM, et al: The role of peritoneal lavage in the management of stab wounds to the abdomen . Am J Surg 1980;140:60-64.Crossref 5. Oreskovich MR, Carrico CJ: Stab wounds of the anterior abdomen: Analysis of a management plan using local wound exploration and quantitative peritoneal lavage . Ann Surg 1983;198:411-419.Crossref 6. Canizaro PC, Fitts CT, Sawyer RB: Diagnostic abdominal paracentesis: A proposed adjunctive measure , in US Army Surgical Research Unit Annual Report . Fort Sam Houston, Tex, US Army, 1964. 7. Root HD, Hauser CW, McKinley CR, et al: Diagnostic peritoneal lavage . Surgery 1965;57:633-637. 8. Thompson JS, Moore EE, Duzer-Moore SV, et al: The evolution of abdominal stab wound management . J Trauma 1980;20:478-484.Crossref 9. Shaftan GW: Indications for operation in abdominal trauma . Am J Surg 1960;99:657-664.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Peritoneal Lavage: Reliability of RBC Count in Patients With Stab Wounds to the Chest

Thal, Erwin R.
Archives of Surgery , Volume 119 (5) – May 1, 1984
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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1984.01390170075015
Publisher site
See Article on Publisher Site

Abstract

Abstract • Two hundred thirteen patients with stab wounds to the lower part of the chest and abdomen were reviewed to determine if a lavage RBC count of 100,000/cu mm was a reasonable figure to permit prompt recognition of injury and to minimize the number of negative operative procedures. There were four (1.9%) false-positive and nine (4.2%) false-negative lavages. Three patients (1.4%) had complications due to delayed operation, including one death (0.47%). Two patients (0.9%) had hollow viscus injuries; neither involved the colon. Three of the nine patients with injuries had cell counts of less than 1,000/cu mm. The negative celiotomy rate was 4.2%. It was concluded that the number of missed injuries, delayed operative procedures, and complications was sufficiently low enough to continue recommending 100,000 RBCs per cubic millimeter as a safe number to use as an indication for operation. (Arch Surg 1984;119:579-584) References 1. Thal ER: Evaluation of peritoneal lavage and local exploration in lower chest and abdominal stab wounds . J Trauma 1977;17:642-648.Crossref 2. Engrav LH, Benjamin CI, Strate RG, et al: Diagnostic peritoneal lavage in blunt abdominal trauma . J Trauma 1975;15:854-859.Crossref 3. Hornyak SW, Shaftan GW: Value of inconclusive lavage in abdominal trauma management . J Trauma 1979; 19:329-333.Crossref 4. Galbraith TA, Oreskovich MR, Heimbach DM, et al: The role of peritoneal lavage in the management of stab wounds to the abdomen . Am J Surg 1980;140:60-64.Crossref 5. Oreskovich MR, Carrico CJ: Stab wounds of the anterior abdomen: Analysis of a management plan using local wound exploration and quantitative peritoneal lavage . Ann Surg 1983;198:411-419.Crossref 6. Canizaro PC, Fitts CT, Sawyer RB: Diagnostic abdominal paracentesis: A proposed adjunctive measure , in US Army Surgical Research Unit Annual Report . Fort Sam Houston, Tex, US Army, 1964. 7. Root HD, Hauser CW, McKinley CR, et al: Diagnostic peritoneal lavage . Surgery 1965;57:633-637. 8. Thompson JS, Moore EE, Duzer-Moore SV, et al: The evolution of abdominal stab wound management . J Trauma 1980;20:478-484.Crossref 9. Shaftan GW: Indications for operation in abdominal trauma . Am J Surg 1960;99:657-664.Crossref

Journal

Archives of Surgery – American Medical Association

Published: May 1, 1984

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