Nonoperative management of blunt abdominal trauma. Experience in a regional hospital of the province of Buenos Aires

Abstract

Background: In recent decades, there has been a significant shift toward a more conservative approach to the management of blunt abdominal trauma with an emphasis on preserving organ function; currently, non-operative management (NOM) has become the standard of care for hemodynamically stable patients with solid organ injury.
Objective: The aim of this study was to determine the different clinical variables associated with the success rate of NOM of blunt abdominal trauma with involving solid organs. 
Material and methods: We conducted a retrospective, observational, longitudinal, and analytical study of patients admitted for blunt abdominal trauma between January 1, 2017, and December 1, 2022. The variables evaluated were age, sex, length of hospital stay, complications, transfusion requirements, success rate and mortality.
Results: Between January 2017 and December 2022, of 2590 patients seen in the emergency department, 24 were admitted with a diagnosis of blunt abdominal trauma. Fifteen patients did not meet the inclusion criteria. The mean age of the 9 patients included was 39 years (15-80 years) and 6 were men. Thirty-six percent had grade I and II splenic lesions, 27% had grade II renal lesions, and 18% had grade II hepatic lesions. The success rate of our series was 100% and there were no failures. 
Conclusion: The variables analyzed allowed us to affirm that NOM of blunt abdominal trauma with solid organ injury was feasible and allowed us to achieve a high success rate, without deaths.