• Stefano Pb Cioffi, Stefania Cimbanassi, and Osvaldo Chiara.
• Department of surgical science, Sapienza University of Rome, Rome.
• Curr Opin Crit Care. 2023 Dec 1; 29 (6): 674681674-681.

Purpose Of ReviewThis 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 FindingsAdvances 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.SummaryMultidisciplinary 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.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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