Management of trauma to the parenchymatous organs

The incidence of abdominal trauma is increasing, and is related to both increased violence in the society and to the increased frequency of road traffic accidents. Injuries to the liver, pancreas with duodenum, and kidneys are almost always associated with other lesions, and we see the multi-traumatized patient. Splenic injuries however, may be solitary. Since the duodenum and pancreas lie in the depth of the abdominal cavity, they are to some extent surrounded and cushioned against impact by the overhanging liver, the lower lateral and posterior rib cage and the vertebral column. The spleen, on the other hand, is attached to its vascular pedicle, but very mobile and susceptible of injuries involving deceleration and direct blunt trauma.