Nonoperative management of hepatic, splenic, and renal injuries in adults with multiple injuries.
BACKGROUND
Nonoperative management (NOM) of abdominal solid organ (ASO; liver, spleen, kidney) injuries from blunt trauma in adults has gained acceptance, but multisystem trauma remains a relative contraindication to NOM.


METHODS
We reviewed the charts of 126 adult patients who underwent NOM of an ASO injury for success of NOM, transfusions, and complications. Patients were divided into two groups: group I had isolated ASO injuries (n = 48); group II had an ASO injury and at least one additional injury with an Abbreviated Injury Score > or = 2 (n = 78).


RESULTS
NOM was successful 89.6% of group I and 93.6% of group II patients (p = 0.55). Group II had higher Injury Severity Scores (20.7 +/- 9.8 vs. 8.3 +/- 4.9 p < 0.05) and transfusion requirements (30.8% vs. 14.6%,p < 0.05) than group I. Complication rates were not different (group I, 20.8% vs. 26.9% group II, p = 0.58).


CONCLUSIONS
NOM of ASO injuries may attempted in adult patients with multiple injuries without increased morbidity.
Department of Surgery, University of Vermont College of Medicine, Burlington 05405, USA.
K H
KH
Sartorelli
C
C
Frumiento
F B
FB
Rogers
T M
TM
Osler
D000328:Adult; D003422:Critical Care / Q000379:methods; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007668:Kidney / Q000293:injuries*; D008099:Liver / Q000293:injuries*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009104:Multiple Trauma / Q000628:therapy*; D012189:Retrospective Studies; D013154:Spleen / Q000293:injuries*