Failure of nonoperative management of abdominal solid organ injuries

Abstract

Despite the failures of nonoperative management outlined in this review, the approach has been generally successful. Efforts at improving organ salvage rates and diminishing failures with this approach continue. Notwithstanding our enthusiasm to advance this method of patient care, we must avoid imperiling a subpopulation of patients in our attempt to improve nonoperative management success rates.

Will computed tomography (CT) miss something? The characteristics and pitfalls of torso CT in evaluating patients with blunt solid organ trauma

“…The success of NOM relies on the following criteria: accurate diagnosis of SOIs, maintenance of hemodynamic stability by administration of a limited amount of fluid and absence of associated injuries. [1,2] Thus, trauma surgeons need a diagnostic tool to discover SOIs and to exclude associated injuries. In the early 1980s, computed tomography (CT) became available and improved the diagnosis of SOI in blunt trauma patients.…”

Effectiveness of contrast-enhanced ultrasound in the classification and emergency management of abdominal trauma

“…A similar approach is effective for liver injuries. Nonoperative management has proven to be of unequivocal benefit to the majority of haemodynamically stable paediatric and adult patients who have suffered blunt liver or splenic trauma [25][26][27]. With this approach, rapid and effective imaging technique plays an important role in predicting the need for different treatment modalities, including surgery, minimally invasive management, and conservative treatment [23].…”

Independent Risk Factors for Failure of Nonoperative Management in Patients with Splenic Injury

“…In many studies, 78-98% success rates for NOM have been described (1,2,3,4,5). However, many risk factors have been described in the literature that may lead to failure of NOM.…”