Evaluating the Positive Predictive Value of Alkaline Phosphatase in Diagnostic Peritoneal Lavage (DPL) for the Need of Further Surgery in Patients with Torso Traumas

Abstract

Background: Diagnostic Peritoneal Lavage (DPL) is a routine method for evaluating internal organ damage in patients with blunt or penetrating torso trauma. Internal organ damage can lead to elevated alkaline phosphatase (ALP) levels in the DPL fluid. In this study, the researchers aimed to assess the prognostic value of elevated alkaline phosphatase levels and the need for laparotomy. Methods: In this study, the researchers evaluated 42 patients with torso trauma (18 penetrating and 24 blunt traumas). The ALP was positive for all the patients in DPL (2 IU/mL <). The hemodynamic status was stable, and there were no other positive findings in their DPL. All the patients underwent diagnostic laparoscopy to evaluate the Positive Predictive Value (PPV) of ALP in DPL. Results: There were only three patients with significant laparoscopic findings, none of which required laparotomy. The PPV of ALP in DPL fluid for the diagnosis of internal organ damage was 7.1%. Conclusions: Elevated DPL alkaline phosphatase levels have no predictive value to warrant for further laparotomy in hemodynamically stable patients, who had torso trauma, which had no other positive finding in their DPL.