Evaluation of the outcome of non-operative management in blunt abdominal solid organ injury

Authors

  • Soumya John Department of General Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu
  • Chandru Ravindrakumar Department of General Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu
  • Ramya Ramakrishnan Department of General Surgery, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu

DOI:

https://doi.org/10.18203/2349-2902.isj20161134

Keywords:

Blunt abdominal trauma, Solid organ injury, Non operative management, Surgery

Abstract

Background:Blunt injury to abdomen is one of the most common injuries caused by road traffic accidents. The advent of newer imaging techniques with high resolution Computerised Tomography (CT) scanners has enabled the clinicians to exactly diagnose the extent of the intra-abdominal injuries. These injuries are commonly managed by surgery, but the shift to selective non operative management (NOM) of blunt injuries to abdominal solid organs is one of the most notable trends in the care of trauma.

Methods: The present study is a prospective one to evaluate the outcome of non-operative management of blunt trauma abdomen conducted at Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Chennai from the month of April 2011 to September 2013.

Results:Out of 50 cases, the most common organ to be injured was the liver (32 cases) and of which 27 cases were managed by non-operative method and it is statistically significant (p=0.008). Of the 50 patients, 15 patients got converted. 8 patients (16%) were converted due to fall in Hb, 6 patients (12%) converted due to fall in Hb and hypotension, and one patient (2%) was converted due to persistent fever and features of peritonitis. 35 patients were managed conservatively. 12 out of 15 patients (80%) who underwent laparotomy developed complications, in comparison only 5 out of 35 patients (15%) who were treated conservatively had complication.

Conclusions:In our study, non-operative management was successful in 70% of the patients with good outcome.

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Published

2016-12-08

Issue

Section

Original Research Articles