Peritoneal lavage in children and adolescents with blunt abdominal trauma.

The major cause of death in children is trauma. Although prompt recognition of blunt abdominal injury is essential, physical examination is an inexact means of establishing the diagnosis. One hundred thirty-five blunt trauma victims under 16 years of age underwent open diagnostic peritoneal lavage over a three-year period. The overall accuracy rate of peritoneal lavage was 95.5 per cent, which included true-negatives (65.9%), false-positives (4.5%), and true-positives (29.6%). These were no false-negative results. Of 40 patients with intra-abdominal injuries, five (12.5%) did not require surgical correction. Open diagnostic peritoneal lavage is the single best test for detecting serious intra-abdominal injury following blunt trauma in children and adolescents.