Diagnostic laparotomy may be more accurate than peritoneal lavage for determining the need for subsequent laparotomy after blunt or penetrating abdominal trauma. 15-20% of all diagnostic peritoneal lavages require unnecessary laparotomies.
However, one group decided that in 38 out of 64 patients in whom intraperitoneal blood was found at laparoscopy, no laparotomy was necessary - only one of these patients went on to require further surgical intervention. However, every one of the group in which it was decided to advance to laparotomy after laparoscopic assessment merited this choice.
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