HYPOTHESIS: Nonoperative management of @entity99 (NOMLI) is highly successful and rarely leads to adverse events. DESIGN: Prospective observational study. SETTING: High-volume academic level I @entity130 center. @entity1 : For 26 months, 78 consecutive unselected @entity1 with @entity99 were followed up prospectively. In the absence of hemodynamic instability or signs of hollow visceral @entity130 , NOMLI was offered irrespective of the magnitude of the @entity99 . Main Outcome Measure Failure of NOMLI, defined as a laparotomy after an initial decision to treat the @entity1 nonoperatively. RESULTS: Of the 78 @entity1 , 23 (29%) were operated on immediately, but only 12 (15%) for @entity548 from the liver. All 12 @entity1 required packing in addition to other maneuvers (hepatorrhaphy [n = 8], resection [n = 4], and liver isolation [n = 1]). Of the remaining 55 @entity1 selected for NOMLI, the method failed in 8 for reasons unrelated to the @entity99 : 2 underwent a splenectomy, 1 underwent a nephrectomy, 1 had a small-bowel repair, 1 underwent abdominal decompression for @entity8479 , and 3 underwent a nontherapeutic laparotomy. The success rate of NOMLI was 85% (47 of 55 @entity1 ), but the liver-specific success rate was 100%. Compared with those in whom NOMLI was successful, @entity1 in whom it failed had a higher Injury Severity Score and underwent more blood transfusions, but they had similar @entity99 grades. In total, 66 (85%) of @entity99 did not bleed significantly. No adverse events were attributed to NOMLI. CONCLUSIONS: Nonoperative management of @entity99 is safe and effective regardless of the grade of @entity99 . Failure of NOMLI is caused by associated @entity3511 and not the liver. Fluid and blood requirements, the degree of @entity130 , and the presence of other abdominal organ injuries may help predict failure.

High success with nonoperative management of blunt XXXX : the liver is a sturdy organ.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity3511 :: ('MESH:D000007', 'Disease') :: ['abdominal injuries'] @entity8479 :: ('MESH:D059325', 'Disease') :: ['abdominal compartment syndrome'] @entity99 :: ('MESH:D056486', 'Disease') :: ['liver injuries', 'liver injury'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma', 'injury severity']
@entity99 :: (MESH:D056486,Disease) :: ['hepatic trauma']
