In which of the following clinical situations is peritoneal lavage indicated?

a. A patient with suspected intraabdominal injury who will undergo prolonged general anesthesia for another injury outside the abdomen

c. A patient with an abdominal knife wound

e. A patient with major noncontiguous injuries (i.e., chest and lower extremity)

Peritoneal lavage is a standard technique to detect significant intraabdominal hemorrhage after blunt trauma. Its applicability after low-velocity gunshot or stab wounds is less clear, but it has no place in the evaluation of highvelocity gunshot wounds. Abdominal paracentesis can be used in place of peritoneal lavage when the suspicion of intraabdominal hemorrhage is high and time is critical. Specific indications for peritoneal lavage and blunt trauma include a number of conditions such as a patient with major noncontiguous injuries, a patient with suspected intraabdominal injury in whom physical examination is unreliable or impossible due to the need for prolonged general anesthesia for another injury. Peritoneal lavage is not useful for patients with abdominal gunshot wounds; all of these patients require immediate laparotomy. When local examination of a stab wound suggests penetration to the anterior fascia and peritoneum, diagnostic peritoneal lavage may help discriminate between those with significant and insignificant injuries.