Non-operative management for abdominal solidorgan injuries: A literature review

The philosophy of abdominal injury management is currently changing from mandatory exploration to selective non-operative management (NOM). The patient with hemodynamic stability and absence of peritonitis should be managed non-operatively. NOM has an overall success rate of 80%–90%. It also can red...

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Bibliographic Details
Published in:Chinese journal of traumatology 2022-09, Vol.25 (5), p.249-256
Main Authors: Kanlerd, Amonpon, Auksornchart, Karikarn, Boonyasatid, Piyapong
Format: Article
Language:English
Subjects:
Abdominal injury
Abdominal solidorgan injury
Management of abdominal injury
Nonoperative management of abdominal injury
Review
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Summary:The philosophy of abdominal injury management is currently changing from mandatory exploration to selective non-operative management (NOM). The patient with hemodynamic stability and absence of peritonitis should be managed non-operatively. NOM has an overall success rate of 80%–90%. It also can reduce the rate of non-therapeutic abdominal exploration, preserve organ function, and has been defined as the safest choice in experienced centers. However, NOM carries a risk of missed injury such as hollow organ injury, diaphragm injury, and delayed hemorrhage. Adjunct therapies such as angiography with embolization, endoscopic retrograde cholangiopancreatography with stenting, and percutaneous drainage could increase the chances of successful NOM. This article aims to describe the evolution of NOM and define its place in specific abdominal solid organ injury for the practitioner who faces this problem.
ISSN:1008-1275
1008-1275
DOI:10.1016/j.cjtee.2021.09.006