Limiting computed tomography to patients with peritoneal lavage-positive results reduces cost and unnecessary celiotomies in blunt trauma

Martin Schreiber, Larry M. Gentilello, Peter Rhee, Gregory J. Jurkovich, Ronald V. Maier

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: To determine if computed tomographic (CT) scanning can be used to identify patients with blunt trauma, positive results of diagnostic peritoneal lavage (DPL), and a stable hemodynamic status who could be managed safely and cost-effectively without celiotomy. Design: Patients with blunt trauma who required an abdominal evaluation underwent DPL. Patients with a red blood cell count greater than 1011/L (105/mm3) on lavage then underwent CT. Patients with solid organ injury alone, as detected on CT scan, were observed; those with evidence of hollow viscus injury underwent celiotomy. Results: Sixty-seven hemodynamically stable patients had a red blood cell count greater than 1011/L on DPL; 38 patients underwent subsequent CT scanning, and 29 underwent immediate celiotomy in violation of the protocol. Eleven patients in the protocol group ultimately underwent celiotomy. Overall, there were significantly fewer nontherapeutic celiotomies performed in the protocol group (2/38 vs 9/29, P

Original languageEnglish (US)
Pages (from-to)954-959
Number of pages6
JournalArchives of Surgery
Volume131
Issue number9
StatePublished - Sep 1996
Externally publishedYes

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Peritoneal Lavage
Tomography
Costs and Cost Analysis
Wounds and Injuries
Erythrocyte Count
Viscera
Therapeutic Irrigation
Hemodynamics

ASJC Scopus subject areas

  • Surgery

Cite this

Limiting computed tomography to patients with peritoneal lavage-positive results reduces cost and unnecessary celiotomies in blunt trauma. / Schreiber, Martin; Gentilello, Larry M.; Rhee, Peter; Jurkovich, Gregory J.; Maier, Ronald V.

In: Archives of Surgery, Vol. 131, No. 9, 09.1996, p. 954-959.

Research output: Contribution to journalArticle

Schreiber, Martin ; Gentilello, Larry M. ; Rhee, Peter ; Jurkovich, Gregory J. ; Maier, Ronald V. / Limiting computed tomography to patients with peritoneal lavage-positive results reduces cost and unnecessary celiotomies in blunt trauma. In: Archives of Surgery. 1996 ; Vol. 131, No. 9. pp. 954-959.
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AU - Maier, Ronald V.

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