Nonoperative treatment of blunt trauma to liver and spleen

Nonoperative management of 20 cases of liver injury in 1969-1984 and 13 of splenic injury in 1977-1984, all due to blunt abdominal trauma, is retrospectively reviewed. The total of blunt hepatic injuries treated in the same period was 63 and that of blunt splenic injuries 52. There were no major differences in etiology, age, sex distribution or need for blood transfusion between the liver and splenic trauma cases. After initial resuscitation and diagnostic work-up with angiography, computed tomography, ultrasonography and/or scintiscan, circulatorily stable patients were selected for nonoperative treatment. These patients showed evidence of mild trauma with few associated major injuries, few complications and no mortality. Following initial bedrest and observation, they were gradually mobilized and could leave the hospital after about 2 weeks.