Tribble J B, Julian S, Myers R T
Department of Surgery, Bowman Gray School of Medicine of Wake Forest University Medical Center, Winston-Salem, North Carolina.
J Trauma. 1989 Jan;29(1):116-8. doi: 10.1097/00005373-198901000-00026.
A young man hit by a car while riding his motorcycle presented with reversible hypotension, a compression fracture of C6, fractures of the left femur and of ribs 9-12 on the right, and right hemothorax. A falsely negative peritoneal lavage delayed laparotomy, which, when done, demonstrated two right diaphragmatic rents with bleeding into the right chest from a severe liver injury. Presentation of this case demonstrates that while peritoneal lavage is an excellent way to exclude intraperitoneal hemorrhage following blunt abdominal trauma, false-negative results may occur in the setting of hemorrhage with diaphragmatic rupture.
