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Managing hemodynamically stable patients with thoracoabdominal stab wounds is still under dispute. This study aimed at discussing cut-off points of red blood cell (RBC) count in diagnostic peritoneal lavage (DPL) effluent in these patients. Three hundred and eighty-eight patients with thoracoabdominal stab wounds and hemodynamically stable status were enrolled. In cases without a clear indication of laparotomy, the peritoneal cavity was washed out with 1000 ml of normal saline and the effluent fluid was analyzed for RBC count. RBC counts of >100,000/mm3 in abdominal wounds and of >10,000/mm3 in lower chest wounds were considered as indications for exploratory laparotomy (conventional approach). New cut-off points for RBC count were calculated in backward analysis. Sensitivity and specificity of the conventional approach were 90% and 84%, respectively. RBC counts >15,000/mm3 in abdominal wounds and >25,000/mm3 in lower chest wounds were the best cut-off points in distinguishing patients with and without need of operation, with a sensitivity and specificity of 94% and 96%, respectively. New cut-off points of RBC count in DPL effluent may promote management of patients with thoracoabdominal stab wounds and no obvious indication for operation.

Citation

Shahriar Hashemzadeh, Kamran Mameghani, Rohollah F Fouladi, Elnaz Ansari. Diagnostic peritoneal lavage in hemodynamically stable patients with lower chest or anterior abdominal stab wounds. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES. 2012 Jan;18(1):37-42

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PMID: 22290048

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