Changes in Approach to Solid Organ Injury: What the Radiologist Needs to Know

2020 ◽  
Vol 71 (3) ◽  
pp. 352-361
Author(s):  
Siobhán B. O’Neill ◽  
Saira Hamid ◽  
Savvas Nicolaou ◽  
Sadia R. Qamar
Keyword(s):  
American Association ◽  
Nonoperative Management ◽  
Damage Control ◽  
Management Strategies ◽  
Damage Control Surgery ◽  
Organ Injury ◽  
Solid Organ ◽  
Imaging Findings ◽  
Solid Organ Injury ◽  
Imaging Protocols

This review aims to examine the challenges facing radiologists interpreting trauma computed tomography (CT) images in this era of a changing approach to management of solid organ trauma. After reviewing the pearls and pitfalls of CT imaging protocols for detection of traumatic solid organ injuries, we describe the key changes in the 2018 American Association for the Surgery of Trauma Organ Injury Scales for liver, spleen, and kidney and their implications for management strategies. We then focus on the important imaging findings in observed in patients who undergo nonoperative management and patients who are imaged post damage control surgery.

scholarly journals Risk factors for mortality in blunt abdominal trauma with surgical approach

2015 ◽  
Vol 42 (4) ◽  
pp. 259-264 ◽  
Author(s):  
SILVANIA KLUG PIMENTEL ◽  
GUILHERME VINICIUS SAWCZYN ◽  
MELISSA MELLO MAZEPA ◽  
FELIPE GUILHERME GONÇALVES DA ROSA ◽  
ADONIS NARS ◽  
...  
Keyword(s):  
Risk Factors ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Hemodynamic Instability ◽  
The Other ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Serious Injury ◽  
Serious Injuries

ABSTRACTObjective:identify risk factors for mortality in patients who underwent laparotomy after blunt abdominal trauma.Methods:retrospective study, case-control, which were reviewed medical records of blunt trauma victims patients undergoing laparotomy, from March 2013 to January 2015, and compared the result of the deaths group with the group healed.Results:of 86 patients, 63% were healed, 36% died, and one patient was excluded from the study. Both groups had similar epidemiology and trauma mechanism, predominantly young adults males, automobilistic accident. Most cases that evolved to death had hemodynamic instability as laparotomy indication - 61% against 38% in the other group (p=0.02). The presence of solid organ injury was larger in the group of deaths - 80% versus 48% (p=0.001) and 61% of them had other associated abdominal injury compared to 25% in the other group (p=0.01). Of the patients who died 96% had other serious injuries associated (p=0.0003). Patients requiring damage control surgery had a higher mortality rate (p=0.0099). Only one of 18 patients with isolated hollow organ lesion evolved to death (p=0.0001). The mean injury score of TRISS of cured (91.70%) was significantly higher than that of deaths (46.3%) (p=0.002).Conclusion:the risk factors for mortality were hemodynamic instability as an indication for laparotomy, presence of solid organ injury, multiple intra-abdominal injuries, need for damage control surgery, serious injury association and low index of trauma score.

scholarly journals A Statewide, Population-Based Time-Series Analysis of the Increasing Frequency of Nonoperative Management of Abdominal Solid Organ Injury

1995 ◽  
Vol 222 (3) ◽  
pp. 311-326 ◽  
Author(s):  
Robert Rutledge ◽  
John P. Hunt ◽  
Christopher W. Lentz ◽  
Samir M. Fakhry ◽  
Anthony A. Meyer ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Nonoperative Management ◽  
Population Based ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Series Analysis

Negative Focused Abdominal Sonography for Trauma examination predicts successful nonoperative management in pediatric solid organ injury

2019 ◽  
Vol 86 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Paul McGaha ◽  
Prasenjeet Motghare ◽  
Zoona Sarwar ◽  
Nilda M. Garcia ◽  
Karla A. Lawson ◽  
...  
Keyword(s):  
Nonoperative Management ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Abdominal Sonography

The Failure of Nonoperative Management in Pediatric Solid Organ Injury: A Multi-institutional Experience

2005 ◽  
Vol 59 (6) ◽  
pp. 1309-1313 ◽  
Author(s):  
James H. Holmes ◽  
Douglas J. Wiebe ◽  
Monica 0 Tataria ◽  
Kelly D. Mattix ◽  
David P. Mooney ◽  
...  
Keyword(s):  
Nonoperative Management ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Institutional Experience

Nonoperative Management of Splenic Trauma: An Update

2018 ◽  
Vol 02 (02) ◽  
pp. 172-178
Author(s):  
John Walker ◽  
Aftab Haq ◽  
Rajeev Suri
Keyword(s):  
Endovascular Therapy ◽  
Practice Patterns ◽  
Nonoperative Management ◽  
Organ Injury ◽  
Splenic Trauma ◽  
Solid Organ ◽  
Trauma Centers ◽  
Solid Organ Injury ◽  
Endovascular Interventions ◽  
Trauma Victims

AbstractSplenic injuries continue to be a common solid organ injury among trauma victims. Practice outcomes continue to improve with centers now routinely incorporating endovascular therapy into nonoperative management protocols. Since such incorporation, endovascular practice patterns continue to evolve as more data regarding outcomes concerning approach, embolic techniques, and time to intervention become available. These data are driving trauma centers to adopt multidisciplinary protocols with standardization of triage to nonoperative management, imaging, and endovascular interventions. This review aims to provide the interventionalist with an overview of existing and upcoming practice patterns.

Nonoperative Management of Solid Organ Injury Diminishes Surgical Resident Operative Experience: Is It Time for Simulation Training?

2010 ◽  
Vol 163 (2) ◽  
pp. 179-185 ◽  
Author(s):  
James G. Bittner ◽  
Michael L. Hawkins ◽  
Regina S. Medeiros ◽  
John S. Beatty ◽  
Linda R. Atteberry ◽  
...  
Keyword(s):  
Simulation Training ◽  
Nonoperative Management ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Surgical Resident ◽  
Operative Experience

Intra-abdominal Solid Organ Injuries: An Enhanced Management Algorithm

2014 ◽  
Vol 65 (4) ◽  
pp. 301-309 ◽  
Author(s):  
Nima Kokabi ◽  
Waqas Shuaib ◽  
Minzhi Xing ◽  
Elie Harmouche ◽  
Kenneth Wilson ◽  
...  
Keyword(s):  
American Association ◽  
Nonoperative Management ◽  
Organ Injury ◽  
Grading System ◽  
Low Grade ◽  
Solid Organ ◽  
Imaging Features ◽  
Computed Tomographic ◽  
Management Algorithm ◽  
Pictorial Essay

The organ injury scale grading system proposed by the American Association for the Surgery of Trauma provides guidelines for operative versus nonoperative management in solid organ injuries; however, major shortcomings of the American Association for the Surgery of Trauma injury scale may become apparent with low-grade injuries, in which conservative management may fail. Nonoperative management of common intra-abdominal solid organ injuries relies increasingly on computed tomographic findings and other clinical factors, including patient age, presence of concurrent injuries, and serial clinical assessments. Familiarity with characteristic imaging features is essential for the prompt diagnosis and appropriate treatment of blunt abdominal trauma. In this pictorial essay, the spectrum of the American Association for the Surgery of Trauma organ injury scale grading system is illustrated, and a multidisciplinary management algorithm for common intra-abdominal solid organ injuries is proposed.

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