Nonoperative treatment of blunt injury to solid abdominal organs: A prospective study

George C. Velmahos, Konstantinos G. Toutouzas, Randall Radin, Linda Chan, Demetrios Demetriades, Richard Mullins, Clayton H. Shatney, Daniel R. Margulies, Gill Cryer, Michael E. Lekawa, Gail T. Tominaga, David Wisner, Samuel E. Wilson

Research output: Contribution to journalArticle

172 Citations (Scopus)

Abstract

Hypothesis: Nonoperative management (NOM) of injuries to the liver, spleen, and kidney is highly successful, as shown in retrospective studies, but needs prospective validation. Patients in whom NOM is likely to fail can be identified by specific criteria. Design: Prospective observational study. Setting: Academic level I trauma center at a county hospital. Patients: Two hundred six patients with injuries to the liver (n = 99), spleen (n = 103), and/or kidney (n = 40). Main Outcome Measures: Failure of NOM. Results: Fifty-seven patients (28%) underwent immediate operation; among the other 149, NOM failed in 33 (22%). The rate of failure for spleen injury (34%) was higher than for liver (17%) or kidney injury (18%) (Pα.01). Failure of NOM was due to delayed bleeding from a solid viscus in 20 of the 33 patients. Intestinal injury was detected in only 1 patient initially selected for NOM. Specifically among patients with liver injury, no failure was due to delayed bleeding from the liver. Patients with failed NOM were more likely to have a positive abdominal ultrasonographic finding (61% vs 22%; P

Original languageEnglish (US)
Pages (from-to)844-851
Number of pages8
JournalArchives of Surgery
Volume138
Issue number8
DOIs
StatePublished - Aug 1 2003
Externally publishedYes

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Nonpenetrating Wounds
Prospective Studies
Wounds and Injuries
Liver
Spleen
Therapeutics
Kidney
Hemorrhage
County Hospitals
Viscera
Trauma Centers
Observational Studies
Retrospective Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery

Cite this

Velmahos, G. C., Toutouzas, K. G., Radin, R., Chan, L., Demetriades, D., Mullins, R., ... Wilson, S. E. (2003). Nonoperative treatment of blunt injury to solid abdominal organs: A prospective study. Archives of Surgery, 138(8), 844-851. https://doi.org/10.1001/archsurg.138.8.844

Nonoperative treatment of blunt injury to solid abdominal organs : A prospective study. / Velmahos, George C.; Toutouzas, Konstantinos G.; Radin, Randall; Chan, Linda; Demetriades, Demetrios; Mullins, Richard; Shatney, Clayton H.; Margulies, Daniel R.; Cryer, Gill; Lekawa, Michael E.; Tominaga, Gail T.; Wisner, David; Wilson, Samuel E.

In: Archives of Surgery, Vol. 138, No. 8, 01.08.2003, p. 844-851.

Research output: Contribution to journalArticle

Velmahos, GC, Toutouzas, KG, Radin, R, Chan, L, Demetriades, D, Mullins, R, Shatney, CH, Margulies, DR, Cryer, G, Lekawa, ME, Tominaga, GT, Wisner, D & Wilson, SE 2003, 'Nonoperative treatment of blunt injury to solid abdominal organs: A prospective study', Archives of Surgery, vol. 138, no. 8, pp. 844-851. https://doi.org/10.1001/archsurg.138.8.844
Velmahos, George C. ; Toutouzas, Konstantinos G. ; Radin, Randall ; Chan, Linda ; Demetriades, Demetrios ; Mullins, Richard ; Shatney, Clayton H. ; Margulies, Daniel R. ; Cryer, Gill ; Lekawa, Michael E. ; Tominaga, Gail T. ; Wisner, David ; Wilson, Samuel E. / Nonoperative treatment of blunt injury to solid abdominal organs : A prospective study. In: Archives of Surgery. 2003 ; Vol. 138, No. 8. pp. 844-851.
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