Diagnostic peritoneal lavage

Diagnostic peritoneal lavage (DPL) is performed when intra-abdominal bleeding (hemoperitoneum) usually secondary to trauma is suspected. Nowadays DPL is largely abandoned in favour of abdominal ultrasound. Often surgeons have little experience in performing DPL and haematology departments have troubles analyzing the sample. The procedure is still performed when alternative diagnostic methods such as computerized tomography (CT) or ultrasound imaging are unavailable, or when the patient’s condition does not allow them to be performed. The procedure was first described in 1965.

Procedure
After local anesthesia, a vertical skin incision is made one third of the distance from the umbilicus to the symphisis pubis. The linea alba is divided and the peritoneum entered after it has been picked up to prevent bowel perforation. A catheter is inserted towards the pelvis and aspiration of material attempted using a syringe. If no blood is aspirated, saline is infused and after a few minutes this is drained and sent for analysis.