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

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%) (P