The use of enzyme analysis of peritoneal blood in the clinical assessment of abdominal organ injury.

Seventy patients with blunt and penetrating abdominal trauma and hemoperitoneum were evaluated by the analysis of the enzyme content of peritoneal blood using automated laboratory methods. The enzyme levels in peritoneal blood were evaluated relative to the simultaneous levels in peripheral blood to identify enzyme differences in organ-related peritoneal and periheral blood. The findings in this study indicate that isolated liver injuries are associated with significant elevation of lactic dehydrogenase levels in peritoneal blood and glutamic-oxalacetic transaminase levels in peritoneal and peripheral blood. A multiplicity of abdominal organ injury results in elevation of lactic dehydrogenase and glutamic-oxalacetic transaminase levels in peritoneal blood. The occurrence of isolated small intestinal injury and small intestinal injury combined with other organ injury produces a significant elevation of glutamic-oxalacetic transaminase, lactic dehydrogenase and alkaline phosphatase levels in peritoneal blood. The alkaline phosphatase elevation in peritoneal blood is associated with normal mean values in peripheral blood; therefore, combined alkaline phosphatase in peritoneal and peripheral blood has potential for use in the identification of small intestinal injury in patients with hemoperitoneum of traumatic origin.