Technique

Diagnostic peritoneal lavage firstly requires a clear explanation to the patient of the procedure.

The procedure entails:

• provided that the urinary tract is intact a urinary catheter should be inserted and the bladder should be emptied
  
  
• a few millilitres of local anaesthetic is infiltrated midway between the symphisis pubis and the umbilicus, or alternatively, midway between the umbilicus and the anterior superior iliac spine
  
  
• at the designated site, lightly incise the skin and then gently insert a trochar and peritoneal dialysis catheter until the peritoneal cavity is reached - the resistance suddenly reduces
  
  
• remove the trochar and fix the catheter in position with a stitch
  
  
• aspirate
  
  
• if no bloody fluid is withdrawn, infuse 1 litre of Ringer's lactate solution over 5-10 minutes:
  • turn the patient from side-to-side
  • siphon the fluid off
  • inspect for level of turbidity
  • send fluid to laboratory for red and white cell counts, bacterial culture, amylase concentration
  • in the case of analysis of ascitic fluid, cytological study and biochemical assays would be requested