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Solid Organ Injury

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Geriatric Trauma and Critical Care

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Abstract

Though there is a paucity of elderly specific data, management of solid organ injuries in the elderly should follow the same basic tenets of management as for all patients. The majority of patients with blunt injury to the liver, spleen, and kidney can be managed nonoperatively unless accompanied by hemodynamic instability or peritonitis. Elderly patients in shock do poorly, and the recognition of shock may be more challenging; thus, early recognition and treatment are important including prompt laparotomy when indicated. Certain caveats present in the elderly should be taken into consideration when deciding on nonoperative management and may include the patient’s physiologic reserve to tolerate hemorrhage or shock should bleeding develop, the use of anticoagulants, presence of comorbid conditions, and underlying renal function should angiography be necessary. Mortality is higher in the injured elderly than for younger patients for both operative and nonoperative management.

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Abbreviations

CT:

Computed tomography

EAST:

Eastern Association for the Surgery of Trauma

GFR:

Glomerular filtration rate

NOM:

Nonoperative management

NTDB:

National Trauma Data Bank

SAE:

Splenic artery embolization

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Author information

Authors and Affiliations

  1. Shock Trauma Center, University of Maryland, 22 South Green St., Baltimore, MD, 21201, USA

    Cherisse Berry MD & Rosemary Kozar MD, PhD

Authors
  1. Cherisse Berry MD
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  2. Rosemary Kozar MD, PhD
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Correspondence to Rosemary Kozar MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Surgery, Stritch School of Medicine Loyola University of Chicago Edward Hines, Jr. Veterans Administration Medical Center, Maywood, Illinois, USA

    Fred A. Luchette

  2. Professor of Surgery, Hofstra School of Medicine Medical Director for Surgical and Perioperative Services, Southside Hospital/Northwell Health, Bay Shore, New York, USA

    Jay A. Yelon

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Berry, C., Kozar, R. (2017). Solid Organ Injury. In: Luchette, F., Yelon, J. (eds) Geriatric Trauma and Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-48687-1_28

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  • DOI: https://doi.org/10.1007/978-3-319-48687-1_28

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-48687-1

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