الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Over the past two decades, there has been a major shift from operative to selective nonoperative management (NOM) of traumatic injuries in blunt abdominal trauma (BAT) including severe solid organ injuries. Selective nonoperative management has become the standard of care and consider as safe and effective method in the management of haemodynamically stable patient with blunt solid abdominal organ injury.
This translated to a reduction in hospital stay, reduce the risk of blood transfusion as well as attendant morbidity and mortality associated with laparotomy.
The increased utilization of NOM is facilitated by the various sophisticated and highly accurate non-invasive imaging tools. The specific tests are selected on the basis of the clinical stability of the patient, the ability to obtain a reliable physical examination. In hemodynamically stable patients with a reliable physical examination, the main diagnostic choice is between CT scanning or FAST (with CT scanning in a complementary role). Hemodynamically unstable patients may be initially evaluated with FAST or DPL.
If the decision has been made to observe the patient and to pursue nonoperative management, close monitoring of vital signs and frequently repeated physical examinations are instituted. Adjunctive laboratory testing, such as serial determination of hemoglobin and hematocrit levels, can also help in nonoperative approach.
This is a prospective non randomized study including all patients presenting to the emergency department of Alexandria Main University with blunt abdominal trauma from the age of 17 to 70 years old who were haemodynamically stable with isolated abdominal trauma and no associated co- morbidity during the period from June 2010 to November 2010. Twenty six (14%) patients were successfully managed non-operatively suffered blunt solid abdominal organ injuries.
Males are predominantly affected by BAT the study included 21(80.8%) males and 5(19.2%) females.BAT affects mainly the young patients with mean age 25.5(25.5+/- 8.5) years in our series. Road traffic accident was the most common mechanism of blunt abdominal trauma in our study It represented (61.5%) followed by falls (15.4%) and physical assault (7.7%).