Management of Solid Organ Injuries of the Abdomen

Kunio Kobayashi

Trauma and Critical Care Center, Teikyo University School of Medicine

The major pathophysiology of solid organ injuries of the abdomen is intraperitoneal hemorrhage which often requires surgery. However, the introduction of modern diagnostic modalities such as US and CT has made it easier to treat those patients with abdominal trauma conservatively, and the number of patients treated nonoperatively has been increasing in recent years. We have treated 156 cases of hepatic injury, 100 cases of splenic injury, 23 cases of pancreatic injury and 67 cases of renal injury during the past 8 years, which were classified according to the classification proposed by the Japanese Association for the Surgery of Trauma (JAST). The type of treatment modality used in those patients were analyzed according to the type of injury to each organ. The results showed that certain types of injury can be treated nonoperatively without any problem. Therefore, the classification by JAST can be a guideline for an appropriate selection of treatment for solid organ injuries of the abdomen. The patients treated non-operatively should be kept under close observation. The patients treated operatively should have minimal operative insult. Gauze packing and a second-look operation should be considered for those with massive intraperitoneal hemorrhage.

Key words
blunt abdominal trauma, hepatic injury, surgical management

Reprint requests
Kunio Kobayashi Trauma&Critical Care Center, Teikyo University School of Medicine
2-11-1 Kaga, Itabashi-ku, Tokyo, 173 JAPAN

Accepted
October 7, 1992

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