NONOPERATIVE TREATMENT OF THE SOLID ABDOMINAL ORGAN INJURIES

Abstract

Nonoperative management of the solid organ injuries (liver, spleen and kidneys) in hemodynamically patients has become the standard of care in the last decade. Computed tomography scan is invaluable in determining appropriate patient selection and to exclude other injuries that may necessitate laparotomy. Nonoperative management strategies primarily consist of careful observation with or without the use of adjunctive angiography. The widespread use of angiographic embolization has increased the number and type of patients that can be safety managed without operative intervention. The increasing use of nonoperative management is based on the low failure rates reported in most studies. Success rates of nonoperative treatment have increase to > 90% for these injuries. Practitioners must remain vigilant, however, because failures of nonoperative management may need immediate intervention. This review will discuss current concepts in nonoperative management, including diagnosis, patient selection, nonoperative treatment strategies, benefits, risks, and complications.