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Among the topics are vascular access techniques, oxygen supplementation and respiratory sampling techniques, abdominocentesis and diagnostic peritoneal lavage, central venous pressure, and cardiopulmonary resuscitation.
Imaging and diagnostic studies useful in the case of spontaneous intra-abdominal hemorrhage include contrast-enhanced CT (4,6-10), CTA (1,4,10) (with arterial or arterial and venous phase contrast), ultrasonography (4,7,9,10) (less useful), diagnostic peritoneal lavage (7), and conventional angiography (7,9,10).
1,4) Diagnostic peritoneal lavage can aid in the diagnosis when blood, food particles, or turbid or bilious fluid is aspirated.
Diagnostic peritoneal lavage has fallen out of favor because, while it is sensitive for intraperitoneal bleeding, it is invasive and does not predict outcome or the need for laparotomy.
FAST has largely supplanted diagnostic peritoneal lavage for blunt trauma assessment.
6,7) The original indication was to detect haemoperitoneum in the emergency department (ED), thereby offering a non-invasive alternative to diagnostic peritoneal lavage (DPL) and also expediting time-critical surgical management for trauma patients.
Conventional radiographs, contrast studies, diagnostic peritoneal lavage, ultrasound and induction of pneumoperitoneum are notoriously unreliable at detecting acute diaphragmatic injuries.