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Technique

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Diagnostic peritoneal lavage firstly requires a clear explanation to the patient of the procedure.

The procedure entails:

  • provided that the urinary tract is intact a urinary catheter should be inserted and the bladder should be emptied

  • a few millilitres of local anaesthetic is infiltrated midway between the symphisis pubis and the umbilicus, or alternatively, midway between the umbilicus and the anterior superior iliac spine

  • at the designated site, lightly incise the skin and then gently insert a trochar and peritoneal dialysis catheter until the peritoneal cavity is reached - the resistance suddenly reduces

  • remove the trochar and fix the catheter in position with a stitch

  • aspirate

  • if no bloody fluid is withdrawn, infuse 1 litre of Ringer's lactate solution over 5-10 minutes:
    • turn the patient from side-to-side
    • siphon the fluid off
    • inspect for level of turbidity
    • send fluid to laboratory for red and white cell counts, bacterial culture, amylase concentration
    • in the case of analysis of ascitic fluid, cytological study and biochemical assays would be requested

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