Selective Non-Operative Management of Ballistic Abdominal Solid Organ Injury in the Deployed Military Setting

2010 ◽  
Vol 156 (1) ◽  
pp. 21-24 ◽  
Author(s):  
A. Wood ◽  
K. Trimble ◽  
M. Louden ◽  
J. Jansen
Keyword(s):  
Operative Management ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Non Operative Management

scholarly journals Management of blunt trauma abdomen in a tertiary care teaching hospital: a surgical audit

2018 ◽  
Vol 5 (6) ◽  
pp. 2177
Author(s):  
Shashikumar H. B. ◽  
Madhu B. S. ◽  
Ajo Sebastian
Keyword(s):  
Blunt Trauma ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care ◽  
Operative Management ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Surgical Audit ◽  
Non Operative Management

Background: Blunt abdominal trauma is a common scenario in Emergency department and the common cause being road traffic accidents. With this study we present our experience with blunt trauma of abdominal solid organ injuries over a period of 12 months.Methods: A retrospective study was conducted among 45 blunt trauma of abdominal solid organ injuries who presented to the emergency room of Department of General Surgery of Mysore Medical College and Research Institute, Mysore from 1st January 17 to 31st December 2017.All date were retrieved from medical records and statistical analysis was performed using Epi info version 7.Results: Mean age of study population was 31.46 years. 78.2% of the patients were males. Thirty-three (73.3%) patients undergone non-operative management. Splenic injury was reported as the most common abdominal solid organ injury followed by liver.Conclusions: With the advent of newer investigative modalities like contrast enhanced computed tomography (CECT) abdomen, more and more cases of blunt trauma abdominal solid organ injury can be managed non-operatively with effective ICU care. High-grade injuries do not preclude non-operative management.

Selective non-operative management of solid organ injury following abdominal gunshot wounds

Injury ◽  
2007 ◽  
Vol 38 (9) ◽  
pp. 1084-1090 ◽  
Author(s):  
Joseph DuBose ◽  
Kenji Inaba ◽  
Pedro G.R. Teixeira ◽  
Antonio Pepe ◽  
Michael B. Dunham ◽  
...  
Keyword(s):  
Gunshot Wounds ◽  
Operative Management ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Non Operative Management ◽  
Abdominal Gunshot Wounds

BET 2: Is early chemical thromboprophylaxis safe in patients with blunt trauma solid organ injury (SOI) undergoing non-operative management (NOM)?

2018 ◽  
Vol 35 (2) ◽  
pp. 127-129 ◽  
Author(s):  
Craig Ferguson ◽  
Jonathan Lewin
Keyword(s):  
Blunt Trauma ◽  
Low Molecular Weight Heparin ◽  
Operative Management ◽  
Organ Injury ◽  
Low Molecular Weight ◽  
Solid Organ ◽  
Clinical Question ◽  
Solid Organ Injury ◽  
Study Type ◽  
Non Operative Management

A short cut review was carried out to establish whether chemical thromboprophylaxis was a safe early intervention in patients with solid organ injury that is being managed non-operatively. Eight papers presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that there is inadequate evidence assessing safety of low molecular weight heparin (LMWH) within 24 hours of trauma. The current available evidence does suggest that administration of LMWH within 48 hours is safe in non-operative management of patients who have sustained solid organ injury from blunt trauma.

scholarly journals A study of role of non-operative management in blunt abdominal trauma with solid organ injury

2018 ◽  
Vol 5 (9) ◽  
pp. 3043
Author(s):  
Atish N. Bansod ◽  
Rohan Umalkar ◽  
Ambrish T. Shyamkuwar ◽  
Amar Singade ◽  
Priyanka Tayade ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Operative Management ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Operative Strategy ◽  
Non Operative Management

Background: The present study of role of non-operative management in blunt abdominal trauma with solid organ injury was done to assess the feasibility and safety of non-operative management in hemodynamically stable patients and identify the causes, predictive factors to delineate the rate of non-operative management failure.Methods: A longitudinal observational study was carried out from September 2013 to November 2015. All cases of blunt trauma abdomen with ultrasonological e/o solid organ injury and were hemodynamically stable were included in study.Results: Total 138 cases presented with a history of blunt trauma abdomen of which 56 cases had ultrasonological evidence of solid organ injury. 8 cases were excluded as 6 of these were hemodynamically unstable at presentation while 1 had bowel perforation and another had severe head injury all requiring operative management. Maximum cases were of age group 21-30 years (41.66%) and 31-40 years (31.25%). 42 (87.5%) cases were male and 6 (12.5%) cases of 48 were females.  28 (66.67%) cases presented as Road Traffic Accident. 28 (66.67%) cases had abdominal pain as the commonest symptom while tenderness in 38 (79.17%) cases and tachycardia in 30 (75%) cases was the predominant sign. Most injuries were seen in spleen 23 (47.92%) cases f/b Liver with 14 (29.12%). Conservative management was successful in 40 (83.33%) cases and failed in 8 (16.67%) cases. Mortality of the study was 1 (2.08%) case.Conclusions: Non-operative strategy is a successful approach in patients who are hemodynamically stable and authors strongly recommend it.

THE FAILURE OF NON-OPERATIVE MANAGEMENT IN SOLID ORGAN INJURY

2005 ◽  
Vol 58 (1) ◽  
pp. 223
Author(s):  
J H. Holmes ◽  
M Tataria ◽  
K D. Mattix ◽  
D J. Wiebe ◽  
D P. Mooney ◽  
...  
Keyword(s):  
Operative Management ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Non Operative Management

scholarly journals 90 Penetrating Abdominal Trauma: Comperative Study Between Operative and Conservative Management

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Shalaby ◽  
M Ibrahim ◽  
T El Faioumy ◽  
M Elmessiry
Keyword(s):  
Abdominal Trauma ◽  
Operative Management ◽  
The Other ◽  
University Hospital ◽  
Organ Injury ◽  
Low Grade ◽  
Trauma Patients ◽  
Solid Organ ◽  
Penetrating Abdominal Trauma ◽  
Non Operative Management

Abstract Aim to Assess the feasibility and safety of selective non-operative management in penetrating abdominal injuries and to identify a protocol for selection of patient’s candidates for non-operative management. Method In this comparative study 40 abdominal stab victims (admitted to Emergency Department of Alexandria Main University Hospital) were selected during 6 months period where 20 patients were suitable for non-operative management according to strict selection criteria whereas the other 20 patients were operated according to clinical and/or radiological indications or on basis of department protocol, the results were compared in view of final outcome. Results In our study, 15 patients were assigned for operative management according to selected clinical and/or radiological indications only 3 of them (20%) had non-therapeutic laparotomies, On the other hand, five patients were explored on basis of department protocol in violation of our indications for exploration; four of them (80%) were non-therapeutic. So, the rate of non-therapeutic laparotomies was significantly higher when done mandatory without selected clinical and radiological indications. Conclusions Assessment of vital signs together with abdominal examination are the most important and dependable tools in decision making in penetrating abdominal trauma patients. Patients with shock on admission (but responding to resuscitation), proved low grade solid organ injury (by CT), and proved intraperitoneal collection (by US or CT) could be managed conservatively regarding that they remain vitally and clinically stable. If failure of conservation occurs, it is usually during the 1st 24 hours after admission.

scholarly journals Intra-Abdominal Solid Organ Injury Management in Pediatrics

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
K Subrumaniam ◽  
Sakti Sakti ◽  
Nur Daliza ◽  
YW Yan
Keyword(s):  
Chest Tube ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Pediatric Population ◽  
Operative Management ◽  
Hemodynamic Instability ◽  
Organ Injury ◽  
Solid Organ ◽  
Significant Morbidity ◽  
Solid Organ Injury

Abdominal trauma is relatively uncommon in children but can leads to a significant morbidity and mortality in the pediatric population. The abdomen is the third most commonly injured anatomic region in children, after the head and the extremities. The abdomen is the most common site of initially unrecognized fatal injury in traumatized children. We are reporting a case of a child with multiple solid organ injury that was successfully treated non-operatively at our center. We presented a previously healthy 9-month-old girl, presented with fluctuating GCS secondary to motor vehicle accident with borderline hemodynamic stability. She was intubated, blood transfusion commenced and a single inotrope support started. She subsequently diagnosed with grade III liver injury, grade II splenic injury, right grade IV renal injury with large perinephric and retroperitoneal hematoma and moderate hemoperitoneum, a non-displaced left superior pubic rami fracture and cerebral edema on computed tomography (CT). She was admitted to pediatric intensive care unit (PICU). Her intra-abdominal injury injuries were successfully treated conservatively. She required a right chest tube on post trauma day 2, for right hemothorax. The chest tube was removed 3 days later following adequate drainage. She eventually was weaned off from ventilator on post trauma day 11. Feeding was commenced on day 7 of post trauma. She was discharge home well after 3 weeks post trauma with periodical follow up. Conclusion: Pediatric intra-abdominal solid organ injury is relatively uncommon, but a potential source of significant morbidity. Non-operative management is the standard of care for the majority of these injuries, which have shown successful rate more than 95%, although continued hemodynamic instability mandates operative intervention.

scholarly journals Renal trauma: a 5-year retrospective review in single institution

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Syarif ◽  
Achmad M. Palinrungi ◽  
Khoirul Kholis ◽  
Muhammad Asykar Palinrungi ◽  
Syakri Syahrir ◽  
...  
Keyword(s):  
Operative Management ◽  
Organ Injury ◽  
Renal Trauma ◽  
Solid Organ ◽  
Mechanism Of Injury ◽  
Current Management ◽  
Injury Management ◽  
Icd 10 ◽  
Non Operative Management ◽  
Overall Mortality

Abstract Background Renal trauma occurs in up to 5% of all trauma cases and accounts for 24% of abdominal solid organ injuries. Renal trauma management has evolved over the past decades, and current management is transitioning toward more conservative approaches for the majority of hemodynamically stable patients. The objective of this study was to analyze the mechanism of injury, management, and outcome in renal trauma. Methods Patients diagnosed with renal trauma in Makassar, Indonesia, from January 2014 to December 2018 were identified retrospectively by the ICD-10 code. Data were collected from medical records. Imaging was classified by radiologists. Variables analyzed included age, sex, mechanism of injury, degree of renal trauma, related organ injury, management, and outcome. Results Out of the 68 patients identified, the average age was 23.9 ± 0.6 years, and most were male (83.8%). Blunt trauma accounted for 89.7% of all cases. The most common renal injuries were grade IV (42.6%), and 14% of the cases had no hematuria. Most patients were treated with non-operative management (NOM). Nephrectomy was performed in 16.2% of cases, and 5.9% of cases underwent renorrhaphy. It was found that 58.8% of cases had isolated renal trauma, and the overall mortality rate (2.9%) was due to related injuries. Conclusions The majority of blunt and penetrating renal trauma cases that are hemodynamically stable have a good outcome when treated with NOM. The presence of injury in other important organs both intra- and extra-abdominally aggravates the patient’s condition and affects the prognosis.

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