Nonoperative management of solid abdominal organ injuries : From past to present

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dc.contributor.author Leppäniemi, A.
dc.date.accessioned 2019-09-10T08:35:01Z
dc.date.available 2019-09-10T08:35:01Z
dc.date.issued 2019-06
dc.identifier.citation Leppäniemi , A 2019 , ' Nonoperative management of solid abdominal organ injuries : From past to present ' , Scandinavian Journal of Surgery , vol. 108 , no. 2 , pp. 95-100 . https://doi.org/10.1177/1457496919833220
dc.identifier.other PURE: 126665680
dc.identifier.other PURE UUID: cb19c734-7c41-4f60-827f-792cd328be41
dc.identifier.other WOS: 000474024300001
dc.identifier.uri http://hdl.handle.net/10138/305350
dc.description.abstract Background and aims: Today, a significant proportion of solid abdominal organ injuries, whether caused by penetrating or blunt trauma, are managed nonoperatively. However, the controversy over operative versus nonoperative management started more than a hundred years ago. The aim of this review is to highlight some of the key past observations and summarize the current knowledge and guidelines in the management of solid abdominal organ injuries. Materials and Methods: A non-systematic search through historical articles and references on the management practices of abdominal injuries was conducted utilizing early printed volumes of major surgical and medical journals from the late 19th century onwards. Results: Until the late 19th century, the standard treatment of penetrating abdominal injuries was nonoperative. The first article advocating formal laparotomy for abdominal gunshot wounds was published in 1881 by Sims. After World War I, the policy of mandatory laparotomy became standard practice for penetrating abdominal trauma. During the latter half of the 20th century, the concept of selective nonoperative management, initially for anterior abdominal stab wounds and later also gunshot wounds, was adopted by major trauma centers in South Africa, the United States, and little later in Europe. In blunt solid abdominal organ injuries, the evolution from surgery to nonoperative management in hemodynamically stable patients aided by the development of modern imaging techniques was rapid from 1980s onwards. Conclusion: With the help of modern imaging techniques and adjunctive radiological and endoscopic interventions, a major shift from mandatory to selective surgical approach to solid abdominal organ injuries has occurred during the last 30-50 years. en
dc.format.extent 6
dc.language.iso eng
dc.relation.ispartof Scandinavian Journal of Surgery
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Abdominal trauma
dc.subject nonoperative management
dc.subject liver
dc.subject spleen
dc.subject pancreas
dc.subject kidney
dc.subject HEPATIC-TRAUMA
dc.subject RENAL TRAUMA
dc.subject STAB WOUNDS
dc.subject GUNSHOT WOUNDS
dc.subject BLUNT
dc.subject LIVER
dc.subject COMPLICATIONS
dc.subject ASSOCIATION
dc.subject ADULTS
dc.subject SAFE
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Nonoperative management of solid abdominal organ injuries : From past to present en
dc.type Review Article
dc.contributor.organization HUS Abdominal Center
dc.contributor.organization II kirurgian klinikka
dc.contributor.organization University of Helsinki
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1177/1457496919833220
dc.relation.issn 1457-4969
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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