Diagnostic peritoneal lavage (DPL)--is it useful decision making process for management of the equivocal acute abdomen?

Patients with a traumatic or non-traumatic acute abdominal conditions often have equivocal findings regarding the need for surgery. Ultrasound and computed tomography, though useful, have limitations and not always available in peripheral hospitals. Diagnostic peritoneal lavage (DPL) was investigated as an aid to decision-making in such patients. After preliminary X-ray and ultrasound, DPL was performed in 50 patients with an equivocal acute abdomen (18 trauma, 32 non-trauma). It was found that overall sensitivity, specificity, accuracy, and positive and negative predictive values were high for patients with trauma. All the above parameters except specificity and negative predictive value (NPV) were also found to be high for the non-trauma group. DPL was found to be a bedside investigation, which helped in taking the decision to operate on patients with both traumatic and non-traumatic acute abdomen.