TO PERFORM OR NOT TO PERFORM DPL? THAT'S THE QUESTION

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Greetings to the List

Actually we still use DPL in cases where the pt have glasgow < 8 and have head
trauma needing urgent surgery (epidural hematoma, significant subdural etc)
Then, at the OR we performed DPL, but it's rare. Otherwise, FAST is our first
choice.

Seldom, we have performed DPL at ICU when, for instance, a pt had been gone to
the OR for a vascular injury, surgery last forever (you know how those bypasses
are in a teaching hospital), bled a lot, received A LOT of cristaloids, blood
etc and the imediate post op FAST (the resident asks for some reason) came
positive.

We had 3 patients whose Fast became positive and while performing DPL, we found
nothing but RINGER and avoid a laparotomy. Why does we decided to do that?
Because we had 2 other patients operated, with nothing else but cristaloids at
the abdominal cavity. 
These are rare cases but one should remind they exist.

Yes, DPL still have a role, performed or not in latin countries

C Alster, MD PhD
University of Sao Paulo Medical School, Brazil

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