International Journal of Clinical Medicine, 2010, 1, 31-36 doi:10.4236/ijcm.2010.11006 Published Online August 2010 (http://www.SciRP.org/journal/ijcm) Copyright © 2010 SciRes. IJCM 31 Non-Operative Management of Blunt Solid Abdominal Organ Injury in Calabar, Nigeria Asuquo Maurice 1 , Bassey Okon 1 , Etiuma Anietimfon 1 , Ngim Ogbu 1 , Ugare Gabriel 1 , Anthonia Ikpeme 2 1 Departments of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria; 2 Departments of Radiology, University of Calabar Teaching Hospital, Calabar, Nigeria. Email: {mauefas, odokwobassey, ogbungim, udeyhenugare, iaikpeme}@yahoo.com, aetiuma@yahoo.co.uk Received August 9 th , 2010; revised August 10 th , 2010; accepted August 12 th , 2010. ABSTRACT Background: Over the past several years, non-operative management has been increasingly recommended for the care of selected blunt abdominal trauma patients with solid organ injuries. Objective: To evaluate the pattern and outcome of blunt abdominal trauma using haemodynamic stability and ultrasonography in the selection of patients for non-operative management in a facility without computed tomogram. Methods: Patients admitted with blunt abdominal trauma between February 2005 and January 2010 were prospectively studied. Haemodynamic stability and sonography formed the basis for selecting patients for non-operative management. Results: In total, 58 patients suffered blunt ab- dominal trauma and 19(33%) patients were successfully managed non-operatively suffered blunt solid abdominal organ injuries. Road traffic accidents inflicted 17(89%) patients while 2(11%) patients sustained sports injury (football). The spleen was the commonest solid organ injured 12(60%), while the liver and kidney were injured in 6(30%) and 2(10%) respectively. Associated injuries were fractured left femur recorded in 3(16%) patients and fractured rib in a patient (5%). Conclusion: Nonoperative treatment is a safe and effective method in the management of haemodynamically sta- ble patient with blunt solid abdominal organ injury. This translated to a reduction in hospital stay, absence of the risk of blood transfusion as well as attendant morbidity and mortality associated with laparotomy. Establishment of trauma system, provision of diagnostic and monitoring facilities, good roads, and education on road safety is recommended for improved outcome. Keywords: Blunt Abdominal Trauma, Solid Organ Injury, Non-Operative Management 1. Introduction The management of patients with blunt abdominal trau- ma (BAT) has evolved over the past two decades with in- crease reliance on a non-operative approach [1,2]. During the past decades, non-operative management (NOM) of haemodynamically stable blunt trauma patients with liver, spleen has become the standard of care [3]. The incre- ased utilization of nonoperative or conservative surgical management of abdominal solid organ injuries is facili- tated by various sophisticated or highly accurate non- invasive imaging tools at the trauma surgeons disposal [2]. Its ability to demonstrate the amount of intra-perito- neal haemorrhage within minutes of patients arrival, so- nography may be considered the screening modality of choice for BAT [4]. Ultrasound is used worldwide to evaluate patients with BAT and sometimes referred to as an extension of phy- sical examination as it is portable, integrates easily into the resuscitation of trauma victims, non invasive and has no associated morbidity [5]. The reliance of haemoperi- toneum as the sole indicator of abdominal visceral injury limits the utility of focused abdominal sonography for trauma (FAST) [2]. We undertook a prospective study of abdominal trau- ma as part of a wider study of the Trauma Research gro- up. This 5-year report sought to evaluate the pattern and outcome of NOM of blunt abdominal solid organ injury in our setting with poor patients and limited facilities for emergency care. 2. Materials and Methods Patients admitted into the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria with BAT from Feb- ruary 2005 through January 2010 were prospectively stu- died. This included biographic data, mechanism, and pat- tern of injuries including associated injuries. Ultrasono- graphy and other investigations included. Ultrasonography findings, haemodynamic stability in