The role of peritoneal lavage in the prediction and treatment of severe acute pancreatitis.

Four practice criteria of severity were assessed on admission in 87 patients with acute pancreatitis. The value of hypotension and hypocalcaemia was limited by their lack of sensitivity (14-32%). Hypoxaemia and a positive peritoneal tap had greater sensitivity (47-55%) without losing diagnostic accuracy (83-84%). The presence of one or more positive criteria discriminated between a 'severe' group of patients with a mortality of 43% and a 'mild' group with a majority of 3% (p less than 0.001). Twenty-three patients with predicted 'severe' disease were randomised to receive peritoneal lavage for 72 h (9) or no lavage (14), but no statistically significant benefit has yet been shown from this treatment.

RCT Entities:   Population Interventions Outcomes