PMID: 6164796May 1, 1981Paper

Value of quantitative cell count and amylase activity of peritoneal lavage fluid

The Journal of Trauma
D Alyono, J F Perry

Abstract

From January 1974 through July 1979, 1,588 patients underwent diagnostic peritoneal lavage. The test had an accuracy of 98.6%, sensitivity of 94.3%, and specificity of 99.8%. It was true positive in 21.9%, false positive in 0.1%, false negative in 1.3%, and true negative in 76.6%. Fifty-nine patients from the true-positive group had grossly equivocal tests, but had positive lavage results based on quantitative cell count. Thus without cell count the test would have a sensitivity of 78.3%, accuracy of 94.8%, and specificity of 99.8. Eight patients had positive lavage based on WBC count but negative RBC count; all of these patients had bowel injuries. Measurement of lavage fluid amylase resulted in minimal or no improvement in the accuracy (0.06%), sensitivity (0.3%), or specificity (0.0%). Five of six patients with positive amylase levels but grossly negative tests had concomitant positive WBC count. The added cost of the amylase measurement is estimated to be $154,472. Peritoneal lavage has high accuracy, sensitivity, and specificity. Cell counts significantly improve sensitivity. Patients with a grossly equivocal test but with a positive cell count should undergo laparotomy. The lavage-fluid amylase measurement is costly and i...Continue Reading

Citations

Dec 1, 1982·American Journal of Surgery·M G GillilandJ H Duke
Jan 1, 1992·Injury·R D SayersK M Porter
Jan 1, 1983·The Journal of Emergency Medicine·G PogorilerE Moore
Jun 24, 1998·The Journal of Trauma·Y OtomoY Yamamoto
Sep 1, 1992·The American Journal of Emergency Medicine·D TandbergG B Demarest
Mar 1, 1997·Annals of Emergency Medicine·K E NordenholzH K Liang
Feb 1, 1983·Annals of Emergency Medicine·R E BurneyJ R Mackenzie
Feb 1, 1983·Annals of Emergency Medicine·T F PhillipsR A Cowley
Dec 1, 1984·American Journal of Surgery·D V FelicianoG L Jordan
Aug 1, 1995·The Australian and New Zealand Journal of Surgery·M SugrueS Deane
Jan 1, 1985·Annals of Emergency Medicine·J A MarxJ A Tercier
May 1, 1984·The American Journal of Emergency Medicine·J T SturmJ F Perry
Mar 1, 1989·Postgraduate Medicine·C F Feied

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