I Trauma Center were analysed to assess the role of peritoneal lavage and urological studies in the initial evaluation. Important hypotension was present in 46 per cent of patients on arrival. Four patients in refractory hypotension despite vigorous resuscitation had positive results. Laparotomy was carried out in 10 of 50 patients. IVP or cystography was performed in 25 of 50 patients.
Peritoneal lavage is recommended on a selective basis in patients with pelvic fractures.
Microscopic haematuria does not warrant contrast studies of the urinary tract. Twenty-six of these patients had had a negative lavage result negative lavage result. There had been no false-negative results in this group, although six patients required operations for extraperitoneal injuries. Four of the eight detahs were due to uncontrollable bleeding that resulted from exploration of the retroperitoneal hematoma. These data suggest that a negative lavage result is highly reliable in the patient with a pelvic fracture and should allow management with confidence that there is no severe intraperitoneal injury.