title: Nonoperative Management of Blunt Solid Organ Injury in Pediatric Surgery.
abstract: In the last decade, higher rates of nonoperative management of liver, spleen, and kidney injuries have been achieved. An algorithmic approach may improve success on a national level. Factors for success include management strategy based on physiologic status of the child, early attempt at resuscitation using blood products, and appropriate use of adjuncts. Shorter hospitalizations are appropriate for children who have not bled significantly, and discharge instructions facilitate the safety of early discharge. Although routine imaging is not required for liver or spleen injury, symptoms should prompt reevaluation. Reimaging of renal injuries remains in common use.
authors.affiliation: Department of Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA; Trauma Department, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ 85006, USA; Department of Child Health, University of Arizona College of Medicine, 550 East Van Buren Street, Phoenix, AZ 86004, USA; General and Thoracic Surgery, Mayo Clinic Hospital, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: DNotrica@surgery4children.com.
authors.forename: David M
authors.initials: DM
authors.lastname: Notrica
authors.affiliation: General Surgery Department, Mayo Clinic Hospital, 5777 East Mayo Blvd, Phoenix, AZ 85054, USA.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Linnaus
mesh_terms: D000465:Algorithms; D002648:Child; D019468:Disease Management; D006801:Humans; D010372:Pediatrics / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000628:therapy*
keywords: Blunt trauma; Kidney injury; Liver injury; Management; Pediatric; Review; Spleen injury