By diagnostic peritoneal lavage we mean a physical exploration of the abdomen which can be of great use to formulate a correct diagnosis. It can also be applied as a therapy in certain clinical conditions.
Today, diagnostic peritoneal lavage is a highly reliable medical test, as results are rarely false positives or other errors. It is also done in conjunction with other imaging tests, such as CT (Computed Axial Tomography) or MRI (Magnetic Resonance Imaging).
The peritoneum is composed of a thin and very strong membrane that is found in the abdominal cavity. It therefore has two layers that join the outermost part of the bowels (visceral peritoneum) and the external part of the abdomen (parietal peritoneum).
Among these is the peritoneal cavity, in which a small amount of fluid is stored. Thanks to it, the rubbing or friction between the different layers is reduced, as it acts as a lubricant.
Normally it performs important functions of support or protection of the organs at the height of the abdomen. However, its functions can be compromised if the peritoneum suffers from an abnormality that develops from disease, trauma, and so on.
How is diagnostic peritoneal lavage performed?
First, the medical and nursing staff will prepare everything needed for the surgery. At this stage, doctors should follow normal hygiene rules and explain the procedure to the patient as far as possible.
On the other hand, diagnostic peritoneal lavage can often be contraindicated or not recommended. For example, if the patient has undergone several abdominal surgeries. Other factors to consider are obesity, pregnancy, severe cirrhosis, clotting problems, and so on.
Afterwards, the area where the incision will be made will be disinfected and local anesthesia administered. Chemical compounds such as lidocaine are usually employed. In this way, the subject will not experience particular discomfort during the washing procedure.
At this point, we will proceed with a scalpel incision that will cross the different layers of the tissue until it reaches the peritoneum. Using the retractor, the medical team will get a better view of the membrane, always making sure that blood does not flood the exposed abdominal cavity.
In the next step, doctors will proceed with a small incision of the peritoneum. Through this opening, a peritoneal dialysis catheter is introduced. Once positioned, a syringe will be inserted and aspiration will proceed. In case of traces of blood, fecal material, bile, urine or intestinal fluid, the result will be positive and a laparotomy will be performed.
In the event of results other than these, the medical staff will administer a liter of saline solution into the cavity. In this case, you will have to move the stretcher or the patient himself, so that the liquid spreads throughout the cavity and mixes with the blood in the area.
After a few minutes, the liquid from the cavity will be drained naturally (with the help of gravity). In this way, a series of elements are obtained which will be analyzed in a specialized laboratory.
Based on the results obtained, the medical team will determine the cause of the abdominal abnormality. In addition, examinations aimed at obtaining internal images of the abdominal region can be performed, in order to facilitate diagnosis.
Several complications or abnormalities may occur during surgery, such as organ perforation or bleeding.
In any case, the layers of dissected tissue will be sutured with resorbable material. Similarly, a tight bandage can be placed over the wound to promote healing and avoid possible complications or infections.