critical care medicine
How To Do Diagnostic Peritoneal Lavage (DPL)
Indications for Diagnostic Peritoneal Lavage
DPL is indicated in the hemodynamically unstable, unresponsive trauma patient who may be in a facility with limited radiology resources. It may be considered in the following situations: Blunt abdominal trauma Stab wound to the abdomen penetrating the fascia (ie, identified on local wound exploration), or with other concerns for intraabdominal entry (eg, from instrument used, clinical findings) Multiple trauma with shock of unclear etiology, especially in patients with an unreliable physical examination of the abdomen (eg, due to altered mental status as a result of head injury, intoxication, spinal cord injury, or other distracting painful injuries) Rarely, DPL is indicated when imaging is available, such as in hypotension plus an unclear E-FAST examination result or imaging that shows free pelvic fluid caused by ascites rather than blood but no apparent solid organ injury ( References ). 