The conservative management of abdominal injuries
Ahmet Okuş1, Barış Sevinç2, Serden Ay2, Kemal Arslan2, Ömer Karahan2, Mehmet Ali Eryılmaz2
1Department of General Surgery, Faculty of Medicine, Mevlana University, Konya, Turkey
2Department of General Surgery, Konya Teaching Hospital, Konya, Turkey
Abstract
Objective: Non-operative management of abdominal injuries has recently become more common. Especially non-operative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt-penetrating) is discussed.
Material and Methods: All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated.
Results: The study includes 115 patients treated for abdominal trauma at our clinics. The mechanism of trauma was; 60% stab wounds, 23.5% blunt abdominal trauma and 16.5% gunshot wounds. Forty-two patients (36.5%) were operated for hemodynamic instability and / or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively.
Conclusion: Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring.
Keywords: Abdominal injury, abdominal trauma, nonoperative treatment
The study was retrospective and permission of the ethics committee is not required.
Externally peer-reviewed.
Concept - A.O., Ö.K.; Design - A.O., Ö.K.; Supervision - Ö.K., M.A.E.; Funding - A.O., B.S.; Materials - A.O., S.A.; Data Collection and/or Processing - A.O., S.A., B.S., K.A.; Analysis and/or Interpretation - A.O., B.S.; Literature Review - A.O.; Writer - A.O.; Critical Review - Ö.K., M.A.E., K.A.
No conflict of interest was declared by the authors.