Non-operative management of solid organ laceration caused by blunt trauma


Erol V., Uğurlu L., Kuzukiran D., Bozbiyik O., Ünver M., Öztürk Ş., ...Daha Fazla

Acta Medica Mediterranea, cilt.31, sa.2, ss.323-327, 2015 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 31 Sayı: 2
  • Basım Tarihi: 2015
  • Dergi Adı: Acta Medica Mediterranea
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.323-327
  • Anahtar Kelimeler: Blunt trauma, non-operative management
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Aims: This study aims to examine, combined with the literature, the non-operative examination criteria and factors effecting the morbidity and mortality of patients admitted to our clinic as a result of solid organ laceration caused by blunt trauma in those who are non-operatively treated. Materials and methods: In this study, 22 patients with blunt trauma who were non-operatively treated from December 2008 untill May 2014, were studied retrospectively. Parameters included in the study were determined as follows: vital functions at the moment of admittance, radiologic findings, need of blood transfusion and duration of hospital stay. Results: By imaging methods (ultrasonography, computed tomography) it was determined that 11 out of 22 patients of the patients had a liver laceration (grade 1-2) and 11 (50%) had a spleen laceration (grade 1-4). Nineteen patients were not observed with hematocrit or hemoglobin decrease, which would have caused the need of a blood transfusion. One patient with spleen laceration grade 4 and treated with non-operative medical monitoring (NOM) received 4 red blood cell (RBC) units; 1 patient with grade 3 spleen laceration who was operated on in the 24th hour of NOM received 4 RBC units; 1 patient with grade 4 spleen laceration who was operated on in the 10th hour of NOM received 5 RBC units. All patients were discharged without development of any complications or mortality. Conclusion: The non-operative treatment of solid organ laceration caused by blunt force trauma is a modern treatment method that can be effectively and safely applied to patients who do not have acute abdominal findings and whose vital findings remain stable, especially when located at experienced and specialized centers. Presently it is possible for patients who are monitored non-operatively to be treated safely with low morbidity and mortality rates thanks to the advanced technology of radiologic examinations and to the growing experience on this matter.