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Henry Ford Hospital Medical Journal

Abstract

Prospectively, 637 patients with blunt or penetrating trauma to the lower chest or abdomen had quantitative peritoneal lavage red blood cell (RBC) and white blood cell (WBC) counts as part of their initial diagnostic evaluation. Statistically, the lavage RBC count (error rate: 6.8%) was a superior test to the lavage WBC count (error rate: 9.7%) (chi sq=9.2564, p=0.0024). See Appendix. When the lavage RBC and WBC tests agreed, the predictive value was high: 94% (46/49) when both were positive and 95% (521/549) when both were negative. When the lavage RBC test was positive and the lavage WBC test was negative, 96% (23/24) of patients had intraabdominal injury. When the lavage WBC test was positive and the lavage RBC test was negative, 60% (9/75) had intraabdominal injury. Six of these patients had injuries only to a hollow viscus (small bowel, 5; colon, 1). Both lavage RBC and WBC tests were useful in this series. When they agreed, each was a good corroborative test. When they did not agree, the lavage RBC test was superior when it was positive. Laparotomy should be considered for the trauma patient whose lavage WBC test is positive.

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