PERITONEAL-FLUID LACTIC-ACID AND DIAGNOSTIC DILEMMAS IN ACUTE ABDOMINAL DISEASE

Our previous canine research suggested that the determination of perit oneal fluid lactic acid levels may he helpful in the evaluation of pot ential acute abdomen cases. To investigate the clinical significance o f those findings, we obtained simultaneous peritoneal and plasma lacti c acid values from patients undergoing emergency celiotomy or in whom surgical consultation was sought to rule out an acute abdomen. The lac tic acid value was significantly higher in peritoneal fluid than in pl asma in patients who were found to have hollow viscus perforation, gan grenous intestine, peritonitis, or intra-abdominal abscess. In contras t, the values were similar in patients who did not have those conditio ns. Our findings suggest that the calculated difference between simult aneous peritoneal and plasma lactic acid values is a helpful diagnosti c index for patients in whom the diagnosis of acute abdomen is not oth erwise obvious.