Interpretation Challenge of Deep Peritoneal Lavage in a Trauma Patient with Liver Cirrhosis: A Case Report Study

 Trauma is one of the most common surgical emergencies. Deep peritoneal lavage (DPL) is an invasive rapid test for detecting intra-abdominal hemorrhage or hollow viscus damage.

 However, there seems to be a defect in the interpretation of DPL in cirrhotic patients.

 The authors reported a 54-year-old male patient who was a known case of cryptogenic liver cirrhosis and was referred due to falling. On the seventh day of admission, due to the persistence of abdominal distention and food intolerance, the medical team decided to conduct DPL to investigate hollow viscera damage. Since the peritoneum fluid analysis expressed a positive finding, the team decided that the patient should undergo explorative laparotomy. Intraoperative findings included cirrhotic liver with ascites without any evidence of bile secretions and intestinal contents. Unfortunately, however, the patient died on the 15th day.

 The present case report is the first study on the false-positive DPL results in cirrhotic patients. It showed that positive DPL findings were untrustworthy in cirrhotic patients, and more powerful diagnostic tools are required for laparotomy decisions.