Peritoneal lavage in patients with normal mentation and hematuria after blunt trauma.

The need for diagnostic peritoneal lavage in the confused or obtunded patient with trauma is universally accepted. The use of peritoneal lavage in patients without neurologic impairment is controversial. The usefulness of diagnostic peritoneal lavage in patients with blunt trauma, hematuria and normal mentation was studied. In this subgroup, exploratory laparotomy was required in 44.6 per cent of the patients. Operation was four times more common for nonurogenital than urogenital injuries. Peritoneal lavage was 92 per cent accurate in predicting the need for laparotomy. Omission of peritoneal lavage resulted in either missed injury or serious diagnostic delay in 12 per cent of the patients. Patients presenting with hematuria after blunt trauma need evaluation for associated nonurogenital injury and would be well served by diagnostic peritoneal lavage.