YALE UNIVERSITY CUSHING/WHITNEY MEDICAL LIBRARY Permission to photocopy or microfilm processing of this thesis for the purpose of individual scholarly consultation or reference is hereby granted by the author. This permission is not to be interpreted as affecting publication of this work or otherwise placing it in the public domain, and the author reserves all rights of ownership guaranteed under common law protection of unpublished manuscripts. Date Digitized by the Internet Archive in 2017 with funding from The National Endowment for the Humanities and the Arcadia Fund https://archive.org/details/longtermoutcomesOOguti Long Term Outcomes of Nonoperative Treatment of Blunt Abdominal Trauma A Thesis Submitted to the Yale University School of Medicine in Partial Fulfillment of the Requirements for the Degree of Doctor of Medicine by Matthew Alan Gutierrez 2001 Mil MEDICAL LIBRARY ■AUG 2 4 200) t'-hzA "Til 3 LONG TERM OUTCOMES OF NONOPERATIVE TREATMENT OF BLUNT ABDOMINAL TRAUMA. Matthew A. Gutierrez and Peter B. Angood. Department of Surgery, Washington University Medical Center, Washington University, St. Louis, MO. (Sponsored by Manish Tandon, Department of Surgery, Yale University School of Medicine). The purpose of this study was to determine if nonoperative treatment of blunt liver and splenic injuries has any long-term consequences that may be detrimental to patients. A retrospective review was conducted of 112 adult trauma patients that were treated nonoperatively for blunt abdominal trauma between 1991 and 1998. The patient records were followed up to see if this patient population had an increased occurrence of medical problems that could be related to nonoperative management. Approximately one patient developed post transfusion hepatitis, two patients developed delayed hemorrhage of their injuries but continued to be managed nonoperatively, one patient failed nonoperative treatment and required splenectomy, three patients developed sepsis, and one patient died during nonoperative management from an asthma exacerbation. There was no incidence of small bowel obstruction in the series. It appears from this data that long-term complications related to nonoperative management are minimal, and it should continue to be the treatment of choice in hemodynamically stable patients who sustain blunt abdominal trauma.