Peter Moreno1, Matthias Von Allmen1, Tobias Haltmeier1, Daniel Candinas1, Beat Schnüriger2. 1. Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland. 2. Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland. beat.schnuriger@gmail.ch.
Abstract
BACKGROUND: Non-operative management (NOM) of blunt splenic or liver injuries (solid organ injury, SOI) has become the standard of care in hemodynamically stable patients. However, the incidence of long-term symptoms in these patients is currently not known. The aim of this study was to assess long-term symptoms in patients undergoing successful NOM (sNOM) for SOI. METHODS: Long-term posttraumatic outcomes including chronic abdominal pain, irregular bowel movements, and recurrent infections were assessed using a specifically designed questionnaire and analyzed by univariable analysis. RESULTS: Eighty out of 138 (58%) patients with SOI undergoing sNOM) responded to the questionnaire. Median (IQR) follow-up time was 48.8 (28) months. Twenty-seven (34%) patients complained of at least one of the following symptoms: 17 (53%) chronic abdominal pain, 13 (41%) irregular bowel movements, and 8 (25%) recurrent infections. One female patient reported secondary infertility. No significant association between the above-mentioned symptoms and the Injury Severity Score, amount of hemoperitoneum, or high-grade SOI was found. Patients with chronic pain were significantly younger than asymptomatic patients (32.1 ± 14.5 vs. 48.3 ± 19.4 years, p = 0.002). Irregular bowel movements were significantly more frequent in patients with severe pelvic fractures (15.4 vs. 0.0%, p = 0.025). A trend toward a higher frequency of recurrent infections was found in patients with splenic injuries (15.9 vs. 2.8%, p = 0.067). CONCLUSION: A third of patients with blunt SOI undergoing sNOM reported long-term abdominal symptoms. Younger age was associated with chronic abdominal symptoms. More studies are warranted to investigate long-term outcomes immunologic sequelae in patients after sNOM for SOI.
BACKGROUND: Non-operative management (NOM) of blunt splenic or liver injuries (solid organ injury, SOI) has become the standard of care in hemodynamically stable patients. However, the incidence of long-term symptoms in these patients is currently not known. The aim of this study was to assess long-term symptoms in patients undergoing successful NOM (sNOM) for SOI. METHODS: Long-term posttraumatic outcomes including chronic abdominal pain, irregular bowel movements, and recurrent infections were assessed using a specifically designed questionnaire and analyzed by univariable analysis. RESULTS: Eighty out of 138 (58%) patients with SOI undergoing sNOM) responded to the questionnaire. Median (IQR) follow-up time was 48.8 (28) months. Twenty-seven (34%) patients complained of at least one of the following symptoms: 17 (53%) chronic abdominal pain, 13 (41%) irregular bowel movements, and 8 (25%) recurrent infections. One female patient reported secondary infertility. No significant association between the above-mentioned symptoms and the Injury Severity Score, amount of hemoperitoneum, or high-grade SOI was found. Patients with chronic pain were significantly younger than asymptomatic patients (32.1 ± 14.5 vs. 48.3 ± 19.4 years, p = 0.002). Irregular bowel movements were significantly more frequent in patients with severe pelvic fractures (15.4 vs. 0.0%, p = 0.025). A trend toward a higher frequency of recurrent infections was found in patients with splenic injuries (15.9 vs. 2.8%, p = 0.067). CONCLUSION: A third of patients with blunt SOI undergoing sNOM reported long-term abdominal symptoms. Younger age was associated with chronic abdominal symptoms. More studies are warranted to investigate long-term outcomes immunologic sequelae in patients after sNOM for SOI.
Authors: B Wernick; A Cipriano; S R Odom; U MacBean; R N Mubang; T R Wojda; S Liu; S Serres; D C Evans; P G Thomas; C H Cook; S P Stawicki Journal: Eur J Trauma Emerg Surg Date: 2016-05-11 Impact factor: 3.693
Authors: A B Peitzman; B Heil; L Rivera; M B Federle; B G Harbrecht; K D Clancy; M Croce; B L Enderson; J A Morris; D Shatz; J W Meredith; J B Ochoa; S M Fakhry; J G Cushman; J P Minei; M McCarthy; F A Luchette; R Townsend; G Tinkoff; E F Block; S Ross; E R Frykberg; R M Bell; F Davis; L Weireter; M B Shapiro Journal: J Trauma Date: 2000-08
Authors: Gil Freitas; Olubode A Olufajo; Khaled Hammouda; Elissa Lin; Zara Cooper; Joaquim M Havens; Reza Askari; Ali Salim Journal: Am J Surg Date: 2016-01-06 Impact factor: 2.565
Authors: Mehmet Ilhan; Recep Erçin Sönmez; Abdullah Kut; Safa Toprak; Ali Fuat Kaan Gök; Mustafa Kayıhan Günay; Cemalettin Ertekin Journal: World J Emerg Med Date: 2019