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This procedure is performed when intra-abdominal bleeding (hemoperitoneum), usually secondary to trauma, is suspected. [2]In a hemodynamically unstable patient with high-risk mechanism of injury, peritoneal lavage is a means of rapidly diagnosing intra-abdominal injury requiring laparotomy, but has largely been replaced in trauma care by the use of a focused assessment with sonography for ...
The purpose of a drain is to prevent fluid (blood or other) build-up in a closed ("dead") space, [2] which may cause either disruption of the wound and the healing process or become an infected abscess, with either scenario possibly requiring a formal drainage/repair procedure (and possibly another trip to the operating room).
An example of an internal drain is a ventriculo-peritoneal shunt, which is a tube that connects ventricles of the brain to the peritoneal cavity. This helps remove extra cerebrospinal fluid from the brain. Accurate recording of the volume of drainage as well as the contents is vital to ensure proper healing and monitor for excessive bleeding.
Incision and drainage (I&D), also known as clinical lancing, are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus.
Treatment is with antibiotics and drainage of the abscess; typically guided by ultrasound or CT, through the skin, via the rectum, or transvaginal routes. [3] Occasionally antibiotics may be used without surgery; if the abscess is at a very stage and small. [2] Until sensitivities are received, a broad spectrum antibiotic is generally required. [2]
Initial management consists of immediate blood transfusion if the patient is in hemorrhagic shock. Classically, hemoperitoneum was an indication for emergency surgery to locate the source of bleeding and also to recover spilled blood from the peritoneal cavity and to use it for auto-transfusion if it has not been contaminated by ruptured bowel contents.
A related procedure is laparoscopy, where cameras and other instruments are inserted into the peritoneal cavity via small holes in the abdomen. For example, an appendectomy can be done either by a laparotomy or by a laparoscopic approach. There is no evidence of short-term or long-term advantages for peritoneal closure during laparotomy. [15]
Paracentesis (from Greek κεντάω, "to pierce") is a form of body fluid sampling procedure, generally referring to peritoneocentesis (also called laparocentesis or abdominal paracentesis) in which the peritoneal cavity is punctured by a needle to sample peritoneal fluid. [1] [2]