AI Article Synopsis
- The review discusses recent advancements in nonoperative management of stable blunt abdominal trauma, emphasizing the need for better patient selection for observation-first strategies, especially with high-grade injuries.
- Recent findings highlight the importance of thorough clinical monitoring and appropriate follow-up, using repeated contrast-enhanced CT scans for high-risk cases and considering contrast-enhanced ultrasound for monitoring.
- The role of multidisciplinary trauma teams is vital for managing high-grade injuries, and careful patient selection is key to reducing failure rates and complications.
Article Abstract
Purpose Of Review: This review examines recent advancements in nonoperative management (NOM) of hemodynamically stable blunt abdominal trauma, focusing on expanding patient selection for observation-first strategies, particularly for high-grade solid organ injuries.
Recent Findings: Advances include a more deliberate nonoperative approach, allowing for broader patient inclusion in diagnostic and interventional angiography. Strict clinical monitoring and appropriate follow-up strategies are crucial to identify early signs of clinical progression and complications. Repeated contrast-enhanced CT (CECT) scan can be used for close observation of high-risk injuries, while the repetition of CECTs may be avoided for lower-risk cases, such as specific high-grade kidney injuries. The role of contrast-enhanced ultrasound (CEUS) in detecting sequelae of nonoperative approaches is still debated and has lot of potential, with ongoing trials exploring possible advantages.
Summary: Multidisciplinary trauma teams play a crucial role in nonoperative management, particularly for high-grade injuries. A careful selection of patients is essential to minimize failure rates. Complications of nonoperative and angiographic approaches should be managed according to local expertise.
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| http://dx.doi.org/10.1097/MCC.0000000000001095 | DOI Listing |
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