Experience of Conservative Management of Abdominal Solid Organ Blunt Trauma

Abstract

Abdominal solid organs like liver, spleen and kidneys are one of the most vital organs of the human body. Liver is the second largest organ of human body with about 2 percent of body weight in adults. The spleen is the largest organ of the lymphatic system. Both the kidneys together represent 0.4 percent of the total body weight. They perform many of the vital functions involving excretion and detoxification, coagulation, immune function, absorption and storage of essential minerals and storage and filtration of blood. Injury to the liver, spleen and kidneys are one of the most common solid organ injuries in blunt trauma. The expected line of management includes initial diagnostics and resuscitation in the emergency room (including chest and pelvic X-ray, and bedside ultrasonography) followed by cross-sectional imaging (protocol-based trauma imaging with CT and contrast-enhanced multiphase protocols according to need). Initial resuscitation should be done in parallel with monitoring of vital signs with observation preferably in an ICU or high-dependency ward until definitive imaging and reporting has been completed and a management is planned. Treatment should be planned as per age, presence of co-morbidities, and changes in physiological status of the patient. Non-operative management should be preferred in patients of all ages irrespective of the grade of injury and in the absence of other abdominal injuries requiring interventions provided that the haemodynamic status is stable. Key words: Abdominal, solid, liver, spleen, kidney, injury, non-operative