Bradley J A, Bradley P, McMahon M J
Br J Surg. 1981 Apr;68(4):245-6. doi: 10.1002/bjs.1800680408.
In only 2 of 98 cases with a clinical diagnosis of acute pancreatitis submitted to peritoneal lavage in order to assess severity was the diagnosis found to be wrong. These two cases (one was biliary peritonitis and the other mesenteric infarction) were not differentiated from severe pancreatitis by clinical examination, measurement of plasma amylase, the appearance of the lavage fluid or its amylase or white cell count. One case was exceptional in that the lavage fluid had a faecal odour, and both cases were found to have large numbers of intestinal organisms which were clearly visible on routine microscopy. Scanty commensals (? contaminants) were seen in the lavage fluid of 2 of the 96 patients with acute pancreatitis but no intestinal organisms were found. If peritoneal lavage is used in the management of acute pancreatitis, microscopy of the lavage fluid, carried out as an emergency investigation, might help to detect the occasional case with a false diagnosis.
在98例临床诊断为急性胰腺炎且接受腹腔灌洗以评估严重程度的病例中，只有2例被发现诊断错误。这两例（一例是胆汁性腹膜炎，另一例是肠系膜梗死）通过临床检查、血浆淀粉酶测定、灌洗液外观或其淀粉酶或白细胞计数均无法与重症胰腺炎相鉴别。有一例很特殊，其灌洗液有粪便气味，且两例均发现有大量肠道细菌，在常规显微镜下清晰可见。96例急性胰腺炎患者中有2例的灌洗液中可见少量共生菌（？污染物），但未发现肠道细菌。如果腹腔灌洗用于急性胰腺炎的治疗，作为一项紧急检查对灌洗液进行显微镜检查可能有助于发现偶尔的误诊病例。
