diagnostic peritoneal lavage
Also written as: DPL — Diagnostic Peritoneal Lavage
Minimally invasive procedure to detect intraperitoneal bleeding or contamination in trauma patients.
Full Definition
Diagnostic peritoneal lavage (DPL) is a rapid diagnostic procedure used to evaluate for intraperitoneal hemorrhage or contamination in trauma patients when other imaging modalities are unavailable or unreliable. The procedure involves placement of a peritoneal catheter, typically through a small infraumbilical incision, followed by instillation of warmed saline and subsequent analysis of the returned fluid. Positive criteria include gross blood on return, red blood cell count greater than 100,000/μL, white blood cell count greater than 500/μL, or presence of bile, bacteria, or food particles. While largely superseded by CT imaging in stable patients, DPL remains valuable in hemodynamically unstable patients requiring immediate surgical decision-making. The procedure has high sensitivity for detecting hemoperitoneum but limited specificity for determining the need for operative intervention.
Usage
Usage note: Largely historical in centers with readily available CT, but still relevant in resource-limited settings.
In Context
- "Diagnostic peritoneal lavage revealed gross blood, prompting immediate exploratory laparotomy." — trauma surgery consultation
- "Given the patient's instability, we performed diagnostic peritoneal lavage rather than CT imaging." — emergency department procedure note