Is Endoscopic Sphincterotomy Sufficient in the Treatment of Sump Syndrome? A 25-Year Experience.

Background: Sump syndrome is one of the rare long-term complications of side-to-side choledochoduodenostomy (CD) leading to attacks of cholangitis due to accumulation of food and debris in the common bile duct distal to the anastomosis is one of the rare long-term complications after CD. Methods: Fifteen patients treated with the Sump syndrome in our institution between 1996 and 2023 were retrospectively evaluated for long-term outcome. Results: Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and bile duct clearance was done in 11 patients, while four were subjected to revisional surgery in the form of a Roux-en-Y hepaticojejunostomy. No complications were recorded. There were 5 (38%) recurrences in a median follow-up period of 8 years (10 months-23 years). Of those, 3 patients were treated surgically and two with repeat ERCP. None of the patients developed any cholangiocarcinoma during follow-up. Conclusion: We conclude that although a high recurrence rate was observed, endoscopic treatment may be a valid approach in the treatment of Sump syndrome, with revisional surgery in the form of a Roux-en-Y hepaticojejunostomy as salvage therapy in recurrences.

Surgical reconstruction of major bile duct injuries: Long-term results and risk factors for restenosis.

BACKGROUND: A single-institution retrospective analysis was undertaken to assess long-term results of definitive surgical reconstruction for major bile duct injuries and risk factors for restenosis. METHODS: Patients treated between January 1995 and October 2020 were reviewed retrospectively. The primary outcome measure was patency. RESULTS: Of 417 patients referred to a tertiary center, 290 (69.5%) underwent surgical reconstruction; mostly in the form of a hepaticojejunostomy (n = 281, 96.8%). Major liver resection was undertaken in 18 patients (6.2%). There were 7 postoperative deaths (2.4%). Patency was achieved in 97.4% of primary repairs and 88.8% of re-repairs. Primary patency at three months (including postoperative deaths and stents removed afterwards) in primary repairs was significantly higher than secondary patency attained during the same period in re-repairs (89.3% vs 76.5%, p < 0.01). The actuarial primary patency was also significantly higher compared to the actuarial secondary patency 10 years after reconstruction (86.7% vs 70.4%, p = 0.001). Vascular disruption was the only independent predictor of loss of patency after reconstruction (OR 7.09, 95% CI 3.45-14.49, p < 0.001), showing interaction with injuries at or above the biliary bifurcation (OR 9.52, 95% CI 2.56-33.33, p < 0.001). CONCLUSIONS: Long-term outcome of surgical reconstruction for major bile duct injuries was superior in primary repairs compared to re-repairs. Concomitant vascular injury was independently associated with loss of patency requiring revision.

Follow-up Results of Endovascular Aneurysm Repair Following Abdominal Visceral Debranching

ABSTRACT Introduction: The aim of this study is to present a series of six cases with thoracoabdominal aneurysm treated with hybrid technique in our center. Methods: Between May 2015 and December 2018, the data of six patients with thoracoabdominal aneurysms and various comorbidities who underwent visceral debranching followed by endovascular aortic aneurysm repair were reviewed retrospectively. Results: Patients' mean age was 65.3±19.6 years. All of them were male. Comorbidities were old age, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, previous surgical interventions, and/or esophageal hemangioma. Except for one patient who underwent coronary artery bypass grafting (inflow was taken from ascending aorta), debranching was performed from the right iliac artery. Debranching of four visceral arteries (superior mesenteric artery, celiac trunk, and bilateral renal right arteries) was performed in three patients, of three visceral arteries (superior mesenteric artery, celiac trunk, right renal artery) was performed in one, and of two visceral arteries (superior mesenteric artery, celiac trunk) was performed in two patients. Great saphenous vein and 6-mm polytetrafluoroethylene grafts were used in one and five patients, respectively, for debranching. Endovascular aneurysm repair was performed following debranching procedures as soon as the patients were stabilized. In total, three patients died at the early, mid, and long-term follow-up due to multiorgan failure, pneumonia, and unknown reasons. Conclusion: Hybrid repair of thoracoabdominal aneurysms may be an alternative to fenestrated or branched endovascular stent grafts in patients with increased risk factors for open surgical thoracoabdominal aneurysm repair; however, the procedure requires experience and care.

Follow-up Results of Endovascular Aneurysm Repair Following Abdominal Visceral Debranching.

INTRODUCTION: The aim of this study is to present a series of six cases with thoracoabdominal aneurysm treated with hybrid technique in our center. METHODS: Between May 2015 and December 2018, the data of six patients with thoracoabdominal aneurysms and various comorbidities who underwent visceral debranching followed by endovascular aortic aneurysm repair were reviewed retrospectively. RESULTS: Patients' mean age was 65.3±19.6 years. All of them were male. Comorbidities were old age, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, previous surgical interventions, and/or esophageal hemangioma. Except for one patient who underwent coronary artery bypass grafting (inflow was taken from ascending aorta), debranching was performed from the right iliac artery. Debranching of four visceral arteries (superior mesenteric artery, celiac trunk, and bilateral renal right arteries) was performed in three patients, of three visceral arteries (superior mesenteric artery, celiac trunk, right renal artery) was performed in one, and of two visceral arteries (superior mesenteric artery, celiac trunk) was performed in two patients. Great saphenous vein and 6-mm polytetrafluoroethylene grafts were used in one and five patients, respectively, for debranching. Endovascular aneurysm repair was performed following debranching procedures as soon as the patients were stabilized. In total, three patients died at the early, mid, and long-term follow-up due to multiorgan failure, pneumonia, and unknown reasons. CONCLUSION: Hybrid repair of thoracoabdominal aneurysms may be an alternative to fenestrated or branched endovascular stent grafts in patients with increased risk factors for open surgical thoracoabdominal aneurysm repair; however, the procedure requires experience and care.

The revascularization of the left subclavian artery with a cross over axilloaxillary bypass for the hybrid repair of thoracic aortic aneurysms.

AIM: We present our subclavian artery revascularization experiences in the patients with thoracic aortic aneurysm who underwent hybrid repair. MATERAIL AND METHODS: Between May 2015-December 2018,4 patients underwent TEVAR procedure following axilloaxillary bypass grafting.The mean age of the patients was 72.5 ± 3.01 years.One patient was female and 3 patients were male.Patients had thoracic aortic aneurysms including the left subclavian artery or aberrant right subclavian artery. RESULTS: All patients underwent endovascular stent graft repair following axilloaxillary bypass grafting in the same day.Mortality did not occur in the perioperative period.One patient had graft infection at 8th month of the operation and the graft was removed.He was lost due to pneumonia following the operation.The control computed tomographies of the other 3 patients revealed patent grafts together with successful endovascular interventions and they have been following uneventfully a mean of 27±6.2 months (range:24-32,median:29). CONCLUSION: The risk of stroke,spinal cord ischemia, and upper extremity ischemia are found higher in the patients who underwent coverage of the left subclavian artery without revascularization.The axilloaxillary bypass grafting may be performed in the patients with high risk to prevent carotid artery manipulation and clamping during carotid-subclavian bypass with long term promising patency rates.

OBJETIVO: Presentamos nuestras experiencias de revascularización de la arteria subclavia en los pacientes con aneurisma de aorta torácica sometidos a reparación híbrida. MATERIAL Y MÉTODOS: entre mayo de 2015 y diciembre de 2018, 4 pacientes fueron sometidos a TEVAR después de un injerto de derivación axiloaxilar. La edad media de los pacientes fue 72,5 ± 3,01 años. Un paciente era mujer y 3 pacientes eran varones. Los pacientes tenían aneurismas de la aorta torácica incluyendo el arteria subclavia izquierda o arteria subclavia derecha aberrante. RESULTADOS: Todos los pacientes fueron sometidos a reparación endovascular con endoprótesis vascular en el mismo día después de un bypass axiloaxilar, no hubo mortalidad en el perioperatorio, un paciente presentó infección del injerto a los 8 meses de la operación y se retiró el injerto, se perdió por neumonía Las tomografías computarizadas de control de los otros 3 pacientes revelaron injertos permeables junto con intervenciones endovasculares exitosas y han estado siguiendo sin incidentes una media de 27 ± 6,2 meses (rango: 24-32, mediana: 29). CONCLUSIÓN: El riesgo de ictus, isquemia medular e isquemia de la extremidad superior es mayor en los pacientes sometidos a cobertura de la arteria subclavia izquierda sin revascularización; en los pacientes con alto riesgo se puede realizar un bypass axiloaxilar para prevenir la manipulación de la arteria carótida. y pinzamiento durante la derivación carótido-subclavia con tasas de permeabilidad prometedoras a largo plazo.

Multidrug refractory aggressive metastatic TFE3 (+) renal cell carcinoma: A case report.

BACKGROUND: Transcription factor E3 (TFE3) related renal cell carcinomas constitute a very small percent of all renal tumors in adults. Prognosis mainly depends on the stage of the disease at the time of diagnosis which is often poor. There is yet to be a standardized treatment protocol. Treatment options include agents identical to TFE3(-) cell renal carcinoma treatment. We present a case of a young woman with a rapidly progressing metastatic TFE3 (+) renal cell carcinoma. CASE REPORT: A 31 year old female presented with abdominal mass, distension, nausea. Initial tests and tumor markers found to be normal. Abdominal CT scan revealed a left retroperitoneal mass along with three other neighboring masses in liver manifesting as metastases. Trucut biopsy and immunohistochemical staining confirmed the retroperitoneal mass as TFE3 (+) renal cell carcinoma.Management and outcome: Sunitinib, pazopanib, nivolumab, axitinib treatments are consecutively given after surgery. It is noteworthy that rapid progression was observed under nivolumab treatment. DISCUSSION: During surveillance, rapid progression is noted under consecutive immunotherapy which was unexpected. Thus, there is a need for more standardized treatment protocols and invention of new agents for management of TFE3 (+) renal cell carcinoma.

A new variant of double common bile duct associated with choledochal cyst.

Extrahepatic bile duct duplication is a rare biliary anomaly often associated with conditions like cholecysto-choledocholithiasis, choledochal cyst and malignancy. Precise preoperative diagnosis using conventional radiologic imaging still remains a challenge and use of existing classification system is equally confusing. A female patient diagnosed with choledochal cyst by magnetic resonance cholangiopancreatography was found to have an associated new variant of double common bile duct during surgery. The variant discovered could not be classified by existing classification systems and was missed by preoperative imaging. Recognition of existence of this anomaly that warrants careful dissection during biliary surgery is necessary to avoid inadvertent biliary injury as preoperative diagnosis still remains a challenge. Review of existing classification systems is required to include newly discovered variants.

Endovascular Thoracoabdominal Replacement after Total Abdominal Aortic Debranching.

Marfan syndrome is an inherited connective tissue disorder affecting mainly eyes and skeletal and cardiovascular systems. Cardiovascular involvement may lead to life-threatening aortic pathologies including aneurysms and/or dissections. In this report, the authors present images of a patient with Marfan syndrome with a history of Bentall-De Bono procedure followed by aortic arch and infrarenal aortoiliac replacements who strongly refused conventional open repair and underwent abdominal debranching followed by thoracoabdominal endovascular stent grafting for the treatment of thoracoabdominal aneurysm.

A New Method in Laparoscopic Sleeve Gastrectomy: Reverse Trendelenburg with Right Lateral Tilt Position Prior to Trocar Entry.

BACKGROUND The primary aim of this study was to evaluate the effectiveness of patient positioning prior to trocar entry in laparoscopic sleeve gastrectomy. MATERIAL AND METHODS The records of 300 patients that had a laparoscopic sleeve gastrectomy surgery at Aydin State Hospital from January 2015 until January 2017 were analyzed retrospectively. First, 140 patients who had been placed in the surgical position after the entry of trocars (PAET) were included as the first group, and 160 patients who had been placed in the surgical position before entry of trocars (PBET) were included as the second group. A comprehensive analysis based on the comparison of age, gender, body mass index (BMI), duration of total anesthesia, and incompleteness rate of operations between the two groups was performed. RESULTS The PAET group was composed of 111 females (79.3%) and 29 males (20.7%). The averages of age, BMI, and duration of anesthesia for this group were 36.84, 46.3 kg/m², and 161.56 minutes, respectively. The PBET group was composed of 123 females (76.9%) and 37 males (23.1%). The averages of age, BMI, and duration of anesthesia of this second group were 38.8, 47.4 kg/m², and 120.8 minutes, respectively. In the PAET group, the operations for four patients (2.9%) were never completed; in the PBET group, there was no uncompleted operations (p=0.046). CONCLUSIONS PBET is an effective method which both shortens the operation time and decreases the rate of uncompleted operations.

Duplicated common bile duct: a recipe for biliary injury. Report of a new variant.

Duplicated common bile duct, often associated with conditions like lithiasis, biliary cysts and pancreatobiliary maljunction, could result in highly morbid and potentially fatal biliary injuries. Precise preoperative diagnosis and classification still remain a challenge. A female patient undergoing emergency laparoscopic cholecystectomy for acute calculous cholecystitis sustained iatrogenic bile duct injury. A drainage tube was placed into the injured duct for post-operative conservative management. Post-operative tube cholangiogram revealed a double common bile duct with cystic duct opening distally. This was identified as a new variant not previously reported or classified. However rare, duplicated common bile duct could result in serious iatrogenic bile duct injury if unidentified during surgery. Knowledge of its existence is essential to avoid such injuries as preoperative diagnosis still remains a challenge. A thorough clinical and morphological study of previously reported variants is needed for a comprehensive classification to encompass newly discovered variants.

Analysis of the Istanbul Forensic Medicine Institute expert decisions on recurrent laryngeal nerve injuries due to thyroidectomy between 2008-2012.

OBJECTIVE: The aim of this study was to evaluate the approach of Forensic Medicine Institution for recurrent laryngeal nerve injuries. In addition, parameters that were taken into consideration by Forensic Medicine Institution in the differentiation of complication and malpractice were evaluated. MATERIAL AND METHODS: The files of 38 patients, with recurrent laryngeal nerve injury following thyroidectomy, that were referred to Istanbul Forensic Medicine Institute with request of expert opinion between 2008-2012 were retrospectively investigated. Data regarding expert decisions, age, gender, diagnosis, hospital type, preoperative vocal cord examination, intraoperative nerve monitoring (IONM), identification of nerve injury during operation, repair of nerve during operation, and type of injury were assessed. RESULTS: Surgeons were found to be faulty in all files with bilateral nerve injury, however, one-sided injury files were considered as a medical complication. Twenty-one (55.2%) patients were female, and 17 (44.8%) were male, with a mean age of 35,8 in women, and 34,1 in men. None of these patients had undergone preoperative vocal cord assessment. The recurrent laryngeal nerve was intraoperatively identified in 21 (55.2%) patients, while it was not seen in 17 (44.8%) patients. IONM was not applied in any patients. There was no attempt for nerve repair during any operation. Nineteen patients had unilateral, and 19 patients had bilateral nerve damage. CONCLUSION: Bilateral recurrent laryngeal nerve injuries are considered as malpractice, when imaging or pathology reports fail to state a cause for difficulty in nerve identification.

Approach of forensic medicine to gossypiboma.

OBJECTIVE: The aim of this study was to assess the risk factors and preventive measures for gossypibomas and their medico-legal implications in forensic medicine in the Turkish legal system. MATERIAL AND METHODS: This study involved a retrospective analysis of the records of 39 patients with gossypiboma. Records were available from the Istanbul Forensic Medicine Institution and were surveyed for faulty treatment between 2008 and 2012. Parameters such as distribution of the cases according to specializations, elective and emergency procedures, surgical procedures, radio-opaque sponge and fluoroscopy availability, routine sponge and instrument counting, number of nurses for counting, and control of the operative field by a second surgeon were investigated. RESULTS: All cases were evaluated by the Istanbul Forensic Medicine Institute 3rd Expertise Committee. This committee comprised of specialists from the departments of forensic medicine, orthopedics and traumatology, general surgery, neurology, internal medicine, pediatrics, chest disease, and infectious diseases. All cases were considered as poor medical practice (malpractice) and surgeons were found to be responsible. In 16 of these 39 cases (41%) emergency procedures were performed. No unexpected event was reported in any procedure. In 16 cases (41%), sponge count was performed and was reported to be complete. Operation notes were available in 16 (41%) cases. Control of the operative field was performed by 1 surgeon, and sponge and instrument count was performed by 1 scrub nurse. Radio-opaque sponge and fluoroscopy were available in 9 (23%) centers in these cases. CONCLUSION: Gossypiboma can be prevented not only with surgeons' care but also with adequate support of medical device and material. However, it is considered as a poor medical practice. Presence of only 1 general surgeon in the expertise committee and ignorance of the working conditions by the surgeons should be questioned.

Pure squamous cell carcinoma of the duodenum.

Primary carcinomas of the small intestine are extremely rare neoplasms. Most of these are adenocarcinomas. Primary squamous cell carcinoma (SCC) of small intestine is exceptionally rare with only occasional case reports in the literature. We report here a surgically treated patient with squamous cell carcinoma arising from duodenal diverticula in the third part of the duodenum.

Endovascular treatment for primary aortic angiosarcoma to relieve thoracic aortic stenosis.

Aortic aneurysms and stenosis are widely treated with endovascular procedures in the current era. In this report, we present endovascular stent grafting for symptomatic treatment of severe thoracic aortic stenosis caused by an aortic sarcomatoid carcinoma in a 73-year-old female. The peri- and post-operative courses were complicated with tumor embolisms that were managed by both endovascular and surgical measures.

The retrospective documentation of legal cases with bile duct injury that were submitted for consideration to Istanbul Forensic Medicine Institute by the courts between 2008-2012.

OBJECTIVE: The aim was to evaluate the parameters that were considered by Forensic Medicine in bile duct injury as well as the issues that the physicians were found to be faulty. MATERIAL AND METHODS: The following parameters were investigated in 21 files that were referred to Istanbul Forensic Medicine Institute with request of expert opinion between 2008-2012; expert decisions, patient's age, gender, written patient consent, diagnosis, type of first surgery, surgical complications, timing of complication diagnosis within the scope of complication management, patient's referral timing, troubleshooting procedures and mortality rate. RESULTS: Physicians were found to be faulty in all files. The reason for physician fault was failure to show the necessary professional care and attention in one (4.7%) file, late recognition of injury and late transfer of the patient in 20 (95.3%) files. Written consent had not been obtained in any of the files. Thirteen patients were female (61.9%) and 8 (30.1%) were male, with a mean age of 43.3 years. Nineteen patients had cholelithiasis (90.4%), and two patients (9.5%) had a mass in the head of the pancreas. Cholecystectomy was performed laparoscopically in 15 patients (78.9%), and with open surgery in 4 patients (21.1%). The Whipple procedure was performed in two patients. The diagnosis was made during the operation in one patient (4.7%), and in the post-operative period in 20 patients (95.3%). The time to diagnosis after surgery was between 3-6 days. All of the patients had been referred to third level health care facilities. The timing of transfer was 1 day in the patient who was diagnosed during the operation, and ranged between 4-10 days in those who were diagnosed postoperatively. Reasons for late referral were delays related to pending test results in 12 patients, vague signs in 3 patients, and following-up patients with the thought that the biliary fistula will heal by itself in 5 patients. Mortality was not observed in any of the examined files. CONCLUSION: The issues where physicians were most frequently found to be faulty were failure to obtain written patient consent, late recognition of injury and late transfer of the patient.

Superiority of ceftriaxon to cefazolin in a rat model of obstructive jaundice: an experimental study.

OBJECTIVE: The objective of this study was to evaluate the serum and bile concentrations of cefazolin and ceftriaxone at the third and sixth hours in an experimental obstructive jaundice model and to identify the rate of excretion of these antibiotics into the bile. MATERIAL AND METHODS: Thirty-two Wistar albino rats were used in this study. The bile and serum levels of cefazolin were measured at the third hour in the A1 group and at the sixth hour in the A2 group, with cefazolin administered as 5 mg/rat; while the bile and serum levels of ceftriaxone were studied at the third hour in the B1 group and at the sixth hour in the B2 group, with ceftriaxone administered as 5 mg/rat. RESULTS: After 3 hr of cefazolin administration, the serum concentration in the A1 group reached a mean of 1.8 µg/ml, while the bile concentration was 90% of the serum concentration, with a mean of 1.6 µg/ml; whereas in the B1 group, the third-hour serum concentration of ceftriaxone was 18.6 µg/ml, while the bile concentration was found to be as high as 330% of this level, i.e., 56 µg/ml. The serum value of cefazolin decreased to 1.4 µg/ml in the A2 group and ceftriaxone decreased to 3.7 µg/ml in the B2 group at the sixth hour. CONCLUSIONS: Although the excretory level of cefazolin and ceftriaxone into the bile reaches therapeutic doses, the duration for which these levels are above those required for bactericidal activity is short. Ceftriaxone is better concentrated in the serum and bile than cefazolin.

Repair of an extensive iatrogenic tracheal rupture with a pleural patch and a vascular graft.

Here we describe a 48-year-old woman who suffered a 7-cm rupture in the lower trachea after intubation with a double-lumen tube. We repaired the rupture with a new technique using a pleural patch reinforced by a ringed vascular graft. This technique appears to be appropriate for use in patients who have large tracheal ruptures to avoid tracheal stenosis.

Impact of ligating gonadal or adrenal collateral veins with the left renal vein on renal function and histology in right-nephrectomized rats.

BACKGROUND: In cases of trauma to the left renal vein (LRV), its ligation near the inferior vena cava (IVC) is considered, but the consequences are not always good. We investigated the role of collateral venous drainage after ligation of the LRV by studying the renal function and histology after ligation of the LRV near the IVC alone or with ligation of the gonadal or adrenal collaterals, in right-nephrectomized (RN) rats. MATERIAL AND METHODS: Ligation of the LRV near the IVC alone (group 1) or with ligation of the adrenal (group 2) or gonadal (group 3) collaterals was studied in RN Wistar rats (n=18 per group). The renal histopathology (ischemic cortical necrosis) and functional status (urea, creatinine, sodium, and potassium) were compared. RESULTS: In RN rats, the results were better when ligating the LRV near the IVC alone or with the adrenal collaterals [mortality 4/18 (22.2%) and 3/18 (16.7%), respectively] than when ligating the LRV near the IVC plus the gonadal collaterals [mortality 15/18 (83.3%)] (p<0.0001). All early deaths occurred within three days and resulted from serious histopathological (ischemic cortical necrosis) and functional (increased urea, creatinine, and potassium; decreased sodium) renal damage. CONCLUSION: In right-nephrectomized rats, the LRV near the IVC and the adrenal collateral can be ligated, while the gonadal collateral should be preserved.

The effect of epidermal growth factor on anastomosis, fascia, and skin wound healing.

BACKGROUND: The effect of epidermal growth factor (EGF) on gastrojejunostomy (anastomosis), fascia, and skin wound healing in rats was investigated. METHODS: The animals (rats) were separated into two main groups. In the first group (control group n: 23), rats were fed on standard diet and tap water without administration of EGF. In the second group (EGF group, n: 19), EGF was added to the diet. Skin, fascia, and anastomosis wounds were created on three different locations via laparotomy and gastrojejunostomy in all rats. In both groups, the rats divided into three subgroups were sacrificed on the 3rd, 7th, and 21st days post operatively. Tensile strength of skin and fascia and bursting pressure strength were measured for wound healing in both groups on 3rd, 7th, and 21st days. RESULTS: Anastomosis tensile strength of EGF group on the 3rd day of postoperation was found to be significantly higher than that of the control group and when we compared anastomosis bursting pressure, fascia tensile strength, and skin tensile strength in both groups, we did not find any significant differences. CONCLUSION: The measurements indicated that on the 3rd day EGF administered group, which had a more remarkable fibroblastic activity at gastrojejunostomy site, was superior to the control group only in terms of anastomosis breaking tensile strength.

[The comparison of the results of the conservative treatment between isolated solid organ injuries and those injuries associated with extraabdominal injuries after blunt abdominal trauma between isolated solid organ injuries and those injuries associated with extraabdominal injuries after blunt abdominal trauma]. / Künt karin travmasi sonrasi izole abdominal solid organ yaralanmalari olan olgular ile beraberinde ekstraabdominal yaralanmalari da olan olgularin konservatif tedavi sonuçlarinin karsilastirilmasi.

BACKGROUND: To determine whether conservative treatment in blunt abdominal solid organ injuries associated with extraabdominal trauma is safe or not. METHODS: Between December 1998 and December 2001, 49 patients were admitted with blunt abdominal trauma, 34 of whom were hemodynamically stable. These 34 patients were divided into two groups. Seventeen patients had isolated abdominal solid organ injuries (Group I) and 17 patients had associated extraabdominal injuries (Group II). The results of conservative treatment, blood pressure values, pulse rates, ages, gender, abdominal solid organ injury scores, the etiologies of trauma, the number of the blood transfusions, morbidity and mortality rates, and hospital stays were compared. RESULTS: The blood pressure values and pulse rates as measured in our emergency room, abdominal solid organ injury scores, ages, gender, the results of conservative treatment, the etiologies of trauma, morbidity and mortality rates were similar in both groups. Comparisons between hospital stays and numbers of the blood transfusion have show statistically significant differences in favour of group II. No patients had hollow viscus injury. CONCLUSION: Conservative treatment is safe for hemodynamically stable blunt abdominal trauma patients with solid organ injury but no hollow viscus injury, even if they have extraabdominal injuries. The existence of extraabdominal injuries, however, prolongs the hospital stay and increases the need of the blood transfusion.