4- Quadrant Abdominocentesis

Perform a 4-quadrant abdominocentesis in any patient with free fluid in the abdomen.9 This technique is quick and easy to perform, and usually differentiates abdominal hemorrhage or biliary or urinary tract injury. The general rule of thumb is that a positive peritoneal tap is a reliable indicator that some hemorrhage has occurred or that free urine or bile is in the abdominal cavity, but that a negative tap does not rule these out.

 

Diagnostic Peritoneal Lavage (DPL)

Consider DPL in any MWD in which major abdominal trauma is suspected, but AFAST and abdominocentesis are unrewarding.9 If available, CT or MRI may be better modalities.