Solid Organ Injuries: To Irradiate or Operate?

Area of Science:

• Trauma Surgery
• Interventional Radiology
• Abdominal Imaging

Background:

• Intra-abdominal solid organ injuries (SOI) are a significant cause of morbidity and mortality in trauma patients.
• Traditional surgical management is evolving with advances in interventional radiology (IR).

Purpose of the Study:

• To review recent advances and evidence-based practices for managing intra-abdominal solid organ injuries.
• To emphasize the role of IR as an adjunct to surgical management and complication resolution.

Main Methods:

• Literature review synthesizing recent evidence on SOI management.
• Analysis of the multidisciplinary approach involving surgery and IR.
• Evaluation of decision-making criteria for endovascular versus surgical intervention.

Main Results:

• Endovascular techniques have reformed SOI management into a multidisciplinary approach.
• Choice of treatment depends on hemodynamic status, injury grade, and complication risk.
• Surgery is typically reserved for hemodynamically unstable patients or those refractory to IR.
• IR intervention is effective for active extravasation or high-risk imaging features.
• Combined surgical and IR management reduces mortality in complex liver trauma.

Conclusions:

• IR plays a crucial role as an adjunct to surgery in managing SOI.
• A multidisciplinary approach optimizes outcomes for patients with intra-abdominal solid organ injuries.
• IR is vital for complication resolution and can be a primary treatment modality in select cases.