[Results of conservative treatment for solid abdominal organ trauma].
We analyzed 59 cases of intraabdominal solid organ injury treated at the Surgical Emergency Service of Istanbul Medical School between January 1996 and January 2001. Fifty-six of these cases suffered blunt and 3 penetrating trauma. Twenty-three cases had injuries involving the liver, 14 spleen, 5 kidney, 6 liver and spleen, 6 liver and kidney, 6 spleen and kidney and four liver and kidney. In 4 of splenic and 5 of hepatic injuries Grade IV injuries were detected. Among the cases, 21% were Grade I, 45% were Grade II, 19% were Grade III, and 15% were Grade IV. Associated injuries were: head trauma in 34 cases (57.6%--Glasgow Coma Score under 7 in 6 cases), thoracic trauma in 19 cases (32%), pelvic fracture in 6 cases (10%), vertebral compression fracture in 3 cases (5%). One patient with splenic (Grade III) and hepatic (Grade II) injury, and one patient with Grade IV splenic injury required surgery during close follow-up due to hemodynamic instability. Our failure rate for conservative treatment of solid organ injuries is 3.3%. Three patients with polytrauma in the ICU died (5% mortality rate). Conservative management in solid organ injuries is gaining more popularity every day. Our work, and current studies accept physiologic parameters in the follow-up of solid organ injuries. Conservative treatment guided with hemodynamic stability, accounts almost a 98% success rate.
Ertekin
C
C
Istanbul Universitesi, Istanbul Tip Fakültesi, Genel Cerrahi Anabilim Dali, Acil Cerrahi Servisi 34390 Capa Istanbul.
Akyildiz
H
H
Taviloğlu
K
K
Güloğlu
R
R
Kurtoğlu
M
M
D000007:Abdominal Injuries / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003663:Decision Trees; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000293:injuries; D008099:Liver / Q000293:injuries; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000293:injuries; D015599:Trauma Severity Indices; D014421:Turkey / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*