Non-surgical follow-up success in blunt abdominal trauma. Can we protect patients with blunt abdominal trauma from surgery?

Abstract

Backgrounds: Abdominal traumas have an important place in the emergency room. Historically, surgical intervention was adopted as a treatment method for liver and spleen traumas. However, with the development of imaging methods, the possibility of non-surgical follow-up was obtained. In this study, the advantages and disadvantages of conservative treatment for surgical intervention were investigated. Material and Method:The patients with complaints of blunt abdominal trauma, who were admitted to the third step research center emergency service during the 27-month period and were referred to general surgery, were retrospectively examined.Results: Of patients, 58.2% (n=53) was monitored conservatively, 34.1% (n=31) had splenectomy and 4.4% (n=4) underwent the primary repair due to isolated liver injury, and both splenectomy and liver primary repair were performed in 3.3% (n=3) because of multiple solid organ injury. We observed that the injuries of non-surgical spleen trauma patients changed between grade I and III. All patients with grade IV-V injuries underwent splenectomy. Patients with decreased hematocrit and whose hematocrit did not increase despite erythrocyte replacement were operated on. Conclusion:In this study, it was explained that patients who were followed up without surgery did not need surgery and that both liver trauma and spleen trauma should be given the chance to follow up without surgery.