Idea Exchange: Performing diagnostic peritoneal lavage by fenestrating a catheter
For the procedure, place the patient in left lateral recumbency, and use sedatives and analgesics for patient comfort and restraint. Prepare the ventral abdomen with a wide surgical clip and an aseptic scrub centered on the umbilicus. Advance the fenestrated, over-the-needle catheter completely off the stylet once the tip has penetrated the peritoneal cavity. Attach a syringe to the catheter to obtain a sample. If no peritoneal fluid is obtained, infuse 22 ml/kg of warm, sterile 0.9% sodium chloride solution by gravity through a drip set attached to the catheter. To distribute the saline solution throughout the abdomen, gently massage the abdomen or roll the patient without dislodging the catheter. Either attach a syringe and gently aspirate fluid from the catheter or allow gravity to fill the drip set and fluid bag. Usually, only small volumes of fluid are obtained because of the wide dispersion throughout the abdomen. Submit any fluid obtained for biochemical and cytologic evaluation, including culture and antimicrobial sensitivity testing.Dr. Karl E. Jandrey, DVECC
1. Kolata RJ. Diagnostic abdominal paracentesis and lavage: experimental and clinical evaluations in the dog. J Am Vet Med Assoc 1976;168:697-699.