The conservative management of abdominal injuries

Abstract

Objective: Non-operative management of abdominal injuries has recently become more common. Especially nonoperative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of nonoperative treatment in abdominal trauma (blunt penetrating) is discussed. Material and Methods:All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results:The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion:Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring.

Successful non-operative management of blunt abdominal trauma in highly selective cases. A safe and effective choice

“…Furthermore, splenic trauma is reported to be associated with the highest failure rates of up to 30%. [23,24] Moreover, splenic embolization has limited benefits and is associated with higher rates of re-embolization. [25] Based on these data, no splenic embolization was performed in our study.…”

Radiological Parameters for Conservative Management of Solid Organ Injuries in a Tertiary Care Hospital

“…While Surgical mode of management was the predominant mode of management during the early 1990's, there has been a drastic shift from surgical management to conservative mode of management. [12] This shift from surgical to conservative has been seen especially in Hemodynamically stable patients thanks to the advent of evidence guided approach and developments in radiology.…”

Laparoscopic Surgery for Liver Gunshot Injury

“…Non-operative follow-up in blunt abdominal trauma reduced unnecessary laparotomy rates. [3,4] It is possible to reduce the unnecessary laparotomy rates more and more by performing diagnostic laparoscopy. [5] Non-operative treatment option was not an indication for penetrating abdominal wound due to the risk of missing injuries and the medicolegal issues.…”