Abdomen--interventions for solid organ injury.

Abstract

Non-operative management of solid organ injury after blunt abdominal trauma (BAT) is the widely accepted standard of care in patients who are haemodynamically stable. This is particularly true for blunt hepatic and splenic injuries where success rates for non-operative management often exceed 90%. [30], [43], [41] and [18] There are less established but evolving rates for non-operative management strategies in patients with other solid organ BAT injuries including pancreatic and renal injuries. More controversial indications for non-operative treatment include solid organ injuries in less stable patients and patients with penetrating solid organ injuries. In this article, current concepts in non-operative management of BAT solid organ injuries will be reviewed. Each abdominal organ will be discussed separately. Diagnosis, patient selection, interventional techniques, results and complications will be discussed. Finally, interventional experience in penetrating solid organ injury will be reviewed. Patients with blunt abdominal trauma with no evidence of solid organ injury have a high incidence of hollow viscus and mesenteric injury54 but the imaging and management of these injuries will not be discussed in this article.