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Review
. 2023 Dec 1;29(6):674-681.
doi: 10.1097/MCC.0000000000001095. Epub 2023 Sep 21.

Blunt abdominal trauma: watch and wait

Stefano Pb Cioffi  1   2 , Stefania Cimbanassi  2   3 , Osvaldo Chiara  2   3
Affiliations
Free article
Review

Blunt abdominal trauma: watch and wait

Stefano Pb Cioffi et al. Curr Opin Crit Care. .
Free 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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References

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