Hay J M, Peyrard P, Lautard M, Levard H, Regnard J F, Rea S, Fingerhut A
Hôpital Louis Mourier, Paris-Colombes, France.
Ital J Surg Sci. 1988;18(2):115-20.
The records of 22 consecutive patients with a non-traumatic ill-defined acute abdomen having diagnostic closed peritoneal lavage, were reviewed retrospectively. All patients had one or more risk factors. Peritoneal lavage was performed under visual control and its diagnostic value was based on the comparison with the definitive diagnosis, based on laparatomy and complementary tests. There were 12 positive results with 11 true positives (7 cases of peritonitis, and 4 of visceral necrosis) and 1 false positive. There were 10 negative results with 9 true negatives and 1 false negative. Sensitivity of peritoneal lavage was 0.91%, specificity 0.90%, positive predictivity 0.91% and negativity 0.90%. Overall mortality was 45%. The limits of the procedure appear to be the infections or localized abscesses. Peritoneal lavage as a simple and easy method, is suitable for high-risk patients when the choice is between immediate operation with possible side-effects or delay with possible adverse course of the abdominal lesion, and permits immediate indication for surgery in case of positivity.
回顾性分析了22例连续接受诊断性闭合性腹腔灌洗的非创伤性不明原因急性腹痛患者的记录。所有患者均有一个或多个危险因素。腹腔灌洗在直视下进行，其诊断价值基于与基于剖腹手术和补充检查的最终诊断相比较。有12个阳性结果，其中11个为真阳性（7例腹膜炎，4例内脏坏死）和1例假阳性。有10个阴性结果，其中9个为真阴性和1例假阴性。腹腔灌洗的敏感性为0.91%，特异性为0.90%，阳性预测值为0.91%，阴性预测值为0.90%。总死亡率为45%。该操作的局限性似乎是感染或局限性脓肿。腹腔灌洗作为一种简单易行的方法，适用于高危患者，此时面临的选择是立即手术可能有副作用，还是延迟手术可能导致腹部病变的不良病程，并且在阳性情况下允许立即进行手术指征。
