Nonoperative Management of Hepatic, Splenic, and Renal Injuries in Adults with Multiple Injuries

BACKGROUNDNonoperative management (NOM) of abdominal solid organ (ASO; liver, spleen, kidney) injuries from blunt trauma in adults has gained acceptance, but multisystem trauma remains a relative contraindication to NOM. METHODSWe reviewed the charts of 126 adult patients who underwent NOM of an ASO injury for success of NOM, transfusions, and complications. Patients were divided into two groupsgroup I had isolated ASO injuries (n = 48); group II had an ASO injury and at least one additional injury with an Abbreviated Injury Score ≥ 2 (n = 78). RESULTSNOM was successful 89.6% of group I and 93.6% of group II patients (p = 0.55). Group II had higher Injury Severity Scores (20.7 ± 9.8 vs. 8.3 ± 4.9 p < 0.05) and transfusion requirements (30.8% vs. 14.6%, p < 0.05) than group I. Complication rates were not different (group I, 20.8% vs. 26.9% group II, p = 0.58). CONCLUSIONNOM of ASO injuries may attempted in adult patients with multiple injuries without increased morbidity.