The American journal of emergency medicine
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Diagnostic peritoneal lavage (DPL) is one of the most useful tools in the diagnosis of intraperitoneal injuries secondary to stab wounds. The lavage catheter is inserted into the peritoneal cavity through a surgical incision or a blind puncture. ⋯ We describe 2 cases in which the lavage catheter was inserted through the stab wound itself after local wound exploration clearly demonstrated violation of the peritoneum. We suggest that in anterior abdominal stab wounds, the DPL can be safely and effectively performed through the stab wound if penetration to the peritoneum is diagnosed.
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Few studies have examined visits to hospital EDs and subsequent admission for the treatment of nontraumatic dental emergencies. The present study of Medicaid-eligible adults was conducted to gain a better understanding of the magnitude of this problem. Data tapes describing adult Medicaid patients' hospital ED and admission claims were obtained from the Maryland Medicaid Management Information System. ⋯ The mean total cost for claims associated with hospital admissions was $5793 US dollars, whereas the minimum cost was $949 and the maximum was $43,524 US dollars. Although the frequency of hospital admissions associated with nontraumatic dental emergencies is not great, a hospital admission is among the most extreme consequences of failing to prevent or treat dental problems. Although some hospital admissions related to dental problems could be unavoidable, further studies are needed to better understand mechanisms for reducing the use of EDs for care best provided in community-based dental offices.