Nonoperative treatment of blunt injury to solid abdominal organs

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Abstract
THe shift from routine operative to selective nonoperative management (nom) of blunt injuries to abdominal solid organs is one of the most notable trends in the care of trauma patients during the past 2 decades.1-3 Physicians are becoming increasingly comfortable in managing such injuries nonoperatively. however, it is surprising that, for such a major practice change, our knowledge is mostly based on retrospective data. important issues such as the rate, cause, and predictors of failure of nom have been addressed predominantly through medical record reviews. only a few prospective studies on adult patients report on nom failure.3-9 Two of these studies have a sample size of greater than 100 patients, including 102 and 112 patients with splenic3 and liver4 injuries, respectively, treated by means of nom. the remaining studies include populations ranging from 21 to 61 patients,5-9 and valid conclusions are hard to draw.