• H Markogiannakis, E Sanidas, E Messaris, I Michalakis, G Kasotakis, J Melissas, and D Tsiftsis.
• Department of Surgical Oncology, Herakleion University Hospital, Herakleion Medical School, University of Crete, Herakleion, Crete, Greece. markogiannakis@easy.com
• Acta Chir Belg. 2006 Sep 1;106(5):566-71.

Background And PurposesNon-operative management (NOM) has revolutionized the care of blunt hepatic and splenic trauma patients. The objective of this study is to evaluate treatment of such patients in a Greek level I trauma centre, to identify factors that are important for selecting them for NOM and to investigate for predictors of NOM failure.Material And MethodsWe reviewed the Trauma Registry data of 96 consecutive adult patients admitted with blunt liver and/or splenic injuries over a 4-year period.ResultsImmediately operated patients (32.3%) had lower diastolic arterial pressure (p = 0.02), lower International Classification of Diseases -9th revision Injury Severity Score (ICISS) (p = 0.01), and a higher grade of splenic injury (p = 0.002) than NOM patients. NOM success rate was 80%. No predictors of NOM failure were found ; however, isolated splenic trauma patients failed NOM more frequently than hepatic patients (p = 0.02).ConclusionsNOM of adult blunt hepatic and splenic trauma patients is safe and efficient. Haemodynamic stability, ICISS and the grade of splenic injury are important for selecting these patients for NOM while splenic trauma patients need more intense observation.

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