Nonoperative Treatment of Multiple Intra-Abdominal Solid Organ Injury After Blunt Abdominal Trauma

Yanar, Hakan; Ertekın, Cemalettın; Taviloğlu, Korhan; Kabay, Burhan; Bakkaloglu, H.; Güloğlu, Recep

doi:10.1097/ta.0b013e3180342023

Cited by 79 publications

(86 citation statements)

References 32 publications

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“…Although the number is small, this may support the contention that selected patients with higher-grade injuries to multiple solid organs can be managed non-operatively. Yanar et al [15] reported that multiplicity of solid organ injury is not a predictive marker of NOM failure, and subset analysis of organ combination revealed no association with NOM failure. In our study, 17 patients (21.25%) with grade III and IV injury were treated with NOM successfully.…”

Section: Discussionmentioning

confidence: 99%

“…[13] showed that the rate of failure was 1.1%, the incidence of bowel or diaphragm injuries in association with spleen or liver injury in patients undergoing laparotomy after blunt trauma was reported between 0.5% and 12% in the literature. [13,14] Yanar et al [15] reported one patient for whom NOM failed because of the mesenteric laceration. In our study, one patient (1.25%) was overlooked and had to be operated on due todeterioration of the general condition during the clinical follow-up and small bowel injury was detected.…”

Section: Discussionmentioning

confidence: 99%

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Nonoperative management of blunt hepatic trauma: 80 cases

Özoğul¹,

Kısaoğlu²,

Aydınlı³

et al. 2014

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nonoperative management of blunt hepatic trauma: 80 cases

Özoğul¹,

Kısaoğlu²,

Aydınlı³

et al. 2014

Ulus Travma Acil Cerrahi Derg

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“…This poses a new set of challenges with regards to observation of these patients and management of their potential complications. 5,6 In our study of NOM, age and sex of the patient did not have any influence on the outcome. Majority of our patients were male and maximum number of patients was in the age group of 21 to 40 years.…”

Section: Discussionmentioning

confidence: 73%

Evaluation of the outcome of non-operative management in blunt abdominal solid organ injury

2016

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INTRODUCTIONBlunt injury to abdomen is one of the most common injuries caused by road traffic accidents. It can also result from fall from height, assault with blunt objects, industrial mishaps, sport injuries, bomb blast etc. The rapid deceleration cause the shearing force to tear tissues at interfaces between tissues that are relatively fixed compared to surrounding structures or crush the tissues between external force and vertebral column or rapidly raise the intra-abdominal pressure from external compression causing rupture of hollow organs. The advent of newer imaging techniques with high resolution Computerised Tomography (CT) scanners has enabled the clinicians to exactly diagnose the extent of the intra-abdominal injuries. These injuries are commonly managed by surgery, but the shift to selective non operative management (NOM) of blunt injuries to abdominal solid organs is one of the most notable trends in the care of trauma. The increasing use of non-operative management is based on low failure rates reported in most of the retrospective studies.2 Preservation of the spleen was initially applied in paediatric trauma and later in adults with success rate of 90-95% in children and only 70-80% in adults. Non ABSTRACT Background: Blunt injury to abdomen is one of the most common injuries caused by road traffic accidents. The advent of newer imaging techniques with high resolution Computerised Tomography (CT) scanners has enabled the clinicians to exactly diagnose the extent of the intra-abdominal injuries. These injuries are commonly managed by surgery, but the shift to selective non operative management (NOM) of blunt injuries to abdominal solid organs is one of the most notable trends in the care of trauma. Methods:The present study is a prospective one to evaluate the outcome of non-operative management of blunt trauma abdomen conducted at Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Chennai from the month of April 2011 to September 2013. Results: Out of 50 cases, the most common organ to be injured was the liver (32 cases) and of which 27 cases were managed by non-operative method and it is statistically significant (p=0.008). Of the 50 patients, 15 patients got converted. 8 patients (16%) were converted due to fall in Hb, 6 patients (12%) converted due to fall in Hb and hypotension, and one patient (2%) was converted due to persistent fever and features of peritonitis. 35 patients were managed conservatively. 12 out of 15 patients (80%) who underwent laparotomy developed complications, in comparison only 5 out of 35 patients (15%) who were treated conservatively had complication. Conclusions: In our study, non-operative management was successful in 70% of the patients with good outcome.

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“…In most cases, treatment of injuries has shifted from early surgical treatment to NOM. NOM of blunt abdominal injuries is well established and strategies based on hemodynamic stability and CT scan findings are now widely used in the treatment of solid organ injuries [3][4][5].…”

mentioning

confidence: 99%

“…Over the past three decades multiple studies have shown that NOM of solid organ injuries is effective, with a reported success rate of more than 90% [3][4][5].…”

mentioning

confidence: 99%

Focus on Blunt Solid Organ Injuries

2009

Eur J Trauma Emerg Surg

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Nonoperative Treatment of Multiple Intra-Abdominal Solid Organ Injury After Blunt Abdominal Trauma

Cited by 79 publications

References 32 publications

Nonoperative management of blunt hepatic trauma: 80 cases

Nonoperative management of blunt hepatic trauma: 80 cases

Evaluation of the outcome of non-operative management in blunt abdominal solid organ injury

Focus on Blunt Solid Organ Injuries

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