Is routine re-imaging for high-grade renal injury needed? Retrospective analysis of 1500 abdominal trauma patients from a tertiary care trauma center over 11 years

Alkhayal, Abdullah; Alzughaibi, Mohanad; Alasmari, Faisal A.; Omeyr, Bander Khaled Al; Alsaikhan, Bader; Alasker, Ahmed; Alrabeeah, Khalid; Ghazwani, Yahia; Almannie, Raed; Hamri, Saeed Bin; Noureldin, Yasser A.

doi:10.1007/s00345-023-04297-z

Cited by 1 publication

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“…The authors report that routine surveillance has a limited impact on the clinical management, as clinical deterioration is the main determining factor. They suggest that routine follow-up should only be considered for patients with high-grade injuries to the collecting system, where the persistence or evolution of the lesion after 72 h may require an interventional approach [1 ▪▪ ,36].…”

Section: Text Of the Reviewmentioning

confidence: 99%

Blunt abdominal trauma: watch and wait

Cioffi,

Cimbanassi,

Chiara

2023

Current Opinion in Critical Care

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Purpose This review examines recent advancements in nonoperative management (NOM) of hemodynamically stable blunt abdominal trauma, focusing on expanding patient selection for observation-first strategies, particularly for high-grade solid organ injuries. Recent Findings Advances include a more deliberate nonoperative approach, allowing for broader patient inclusion in diagnostic and interventional angiography. Strict clinical monitoring and appropriate follow-up strategies are crucial to identify early signs of clinical progression and complications. Repeated contrast-enhanced CT (CECT) scan can be used for close observation of high-risk injuries, while the repetition of CECTs may be avoided for lower-risk cases, such as specific high-grade kidney injuries. The role of contrast-enhanced ultrasound (CEUS) in detecting sequelae of nonoperative approaches is still debated and has lot of potential, with ongoing trials exploring possible advantages. Summary Multidisciplinary trauma teams play a crucial role in nonoperative management, particularly for high-grade injuries. A careful selection of patients is essential to minimize failure rates. Complications of nonoperative and angiographic approaches should be managed according to local expertise.

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Section: Text Of the Reviewmentioning

confidence: 99%