The Experts below are selected from a list of 636 Experts worldwide ranked by ideXlab platform
David J. J. Muckart - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Diagnostic Peritoneal Lavage in suspected penetrating abdominal stab wounds using a dipstick technique
British Journal of Surgery, 2005Co-Authors: David J. J. Muckart, M. A. McdonaldAbstract:The total protein content (g/l) and white blood cell count (cells/mm3) Diagnostic Peritoneal Lavage was assessed using a urine dipstick in 46 patients with suspected penetrating abdominal stab wounds and equivocal physical examination. Those patients with a protein content greater than or equal to 1 g/l and white blood cell count of greater than 500 cells/mm3 were submitted to laparotomy while those with lower values underwent observation and repeat physical examination. In all, 26 patients had a positive Lavage and significant injuries were found in 23 of these. Of 18 patients with a negative Lavage, 17 were managed successfully without operation while one patient died from complications related to central venous catheterization. In two patients the Lavage results were equivocal. One underwent a negative laparotomy and the remaining patient recovered uneventfully. The test has a 100 per cent sensitivity and 86 per cent specificity and provides an accurate, cheap, and rapid means of diagnosis of intra-abdominal injury in penetrating trauma.
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unreliability of standard quantitative criteria in Diagnostic Peritoneal Lavage performed for suspected penetrating abdominal stab wounds
American Journal of Surgery, 1991Co-Authors: David J. J. Muckart, Mark A McdonaldAbstract:Thirty-five patients with abdominal stab wounds in whom clinical examination was equivocal on 2 separate occasions underwent Diagnostic Peritoneal Lavage (DPL) prior to laparotomy. The red and white blood cell counts (cells/mm3) of the Lavage effluent were compared with the operative findings. There were 26 positive and 9 unnecessary laparotomies, the latter consisting of 4 negative and 5 non-therapeutic operations. Use of the standard quantitative criteria for red cells in DPL failed to identify significant injury in eight patients (31%), while the standard white cell count missed six injuries (23%). Their combined use resulted in three missed injuries (12%). Two false-positive results occurred using the red cell count alone and four using the white cell count alone, producing a combined false-positive result in four patients (11%). Reducing the cell threshold level to exclude missed injuries would increase dramatically the rate of unnecessary laparotomies. Although the standard quantitative criteria for DPL are superior to clinical assessment in patients with equivocal findings, their use in penetrating trauma does not achieve the same Diagnostic accuracy as in blunt abdominal trauma.
M. A. Mcdonald - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Diagnostic Peritoneal Lavage in suspected penetrating abdominal stab wounds using a dipstick technique
British Journal of Surgery, 2005Co-Authors: David J. J. Muckart, M. A. McdonaldAbstract:The total protein content (g/l) and white blood cell count (cells/mm3) Diagnostic Peritoneal Lavage was assessed using a urine dipstick in 46 patients with suspected penetrating abdominal stab wounds and equivocal physical examination. Those patients with a protein content greater than or equal to 1 g/l and white blood cell count of greater than 500 cells/mm3 were submitted to laparotomy while those with lower values underwent observation and repeat physical examination. In all, 26 patients had a positive Lavage and significant injuries were found in 23 of these. Of 18 patients with a negative Lavage, 17 were managed successfully without operation while one patient died from complications related to central venous catheterization. In two patients the Lavage results were equivocal. One underwent a negative laparotomy and the remaining patient recovered uneventfully. The test has a 100 per cent sensitivity and 86 per cent specificity and provides an accurate, cheap, and rapid means of diagnosis of intra-abdominal injury in penetrating trauma.
P E Chiquito - One of the best experts on this subject based on the ideXlab platform.
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blunt abdominal injuries Diagnostic Peritoneal Lavage ultrasonography and computed tomography scanning
Injury-international Journal of The Care of The Injured, 1996Co-Authors: P E ChiquitoAbstract:The diagnosis of blunt abdominal injuries is one of the most difficult problems in the management of trauma. There is now better understanding of the Diagnostic facilities available. Guidelines regarding the use of Diagnostic Peritoneal Lavage, ultrasonography, or computed tomography scanning should be available in the Accident and Emergency department.
Kevin K Roggin - One of the best experts on this subject based on the ideXlab platform.
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prospective clinical trial of Diagnostic Peritoneal Lavage to detect positive Peritoneal cytology in patients with gastric cancer
Journal of Surgical Oncology, 2013Co-Authors: James J Mezhir, Mitchell C Posner, Kevin K RogginAbstract:Background and Objectives Positive Peritoneal cytology equates M1 disease in patients with gastric cancer. Diagnostic Peritoneal Lavage (DPL) is a proven test to detect occult visceral injury in trauma patients. The objective of this study is to determine whether DPL can be used to assess Peritoneal cytology in patients with gastric cancer. Methods Patients with gastric adenocarcinoma were prospectively enrolled to undergo DPL prior to Diagnostic laparoscopy (DL). Saline was instilled through a percutaneous catheter and fluid was collected for cytology (DPL-cyt). Washings obtained during DL were used as controls (DL-cyt). Results DPL was successful in 22/27 patients (81.5%). Among the 22 successful DPLs, 12 had positive cytology (54.5%). Positive DPL-cyt specimens matched DL-cyt specimens in 12/12 cases (specificity = 100%). One of 10 cases with negative DPL-cyt was positive on the final DL-cyt (sensitivity = 92%). There were six patients with negative DPL-cyt who had visible M1 disease diagnosed with DL (DPL evaluation of M1 disease, sensitivity 54.5%, specificity = 100%). Conclusions DPL is a safe method of detecting positive cytology in patients with gastric cancer, however gross M1 disease may be missed without visual inspection. The specific role of DPL in the staging workup of patients with gastric cancer remains to be determined. J. Surg. Oncol. 2013;107:794–798. © 2013 Wiley Periodicals, Inc.
Myer H Roszler - One of the best experts on this subject based on the ideXlab platform.
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blunt abdominal trauma computed tomography ultrasound or Diagnostic Peritoneal Lavage when and by whom
Emergency Radiology, 1998Co-Authors: Myer H RoszlerAbstract:The most important imaging decision that the clinician must make regarding the patient who sustains blunt abdominal trauma (BAT) is whether the patient is stable enough to undergo computed tomography (CT). CT is the most sensitive and specific examination for the evaluation of BAT. If the patient is unstable, the clinician has three choices: surgery, Diagnostic Peritoneal Lavage, or ultrasound (US). If the patient then stabilizes, a CT scan should be obtained even if the US is negative.