Comparing non-operative management of abdominal solid organ injuries in pediatric and adult blunt trauma: A meta-analysis and systematic review

Non-operative management (NOM) is the preferred approach for hemodynamically stable patients with blunt abdominal trauma (BAT) involving solid organ injuries. It is associated with shorter hospital stays (LOS) and favorable outcomes, particularly in pediatric patients, who have high rates of such injuries. This review assesses the efficacy of NOM in both pediatric and adult populations and compares outcomes between these groups.

A meta-analysis and systematic literature review was performed using databases such as PubMed, MEDLINE, Google Scholar, Springer, and ScienceDirect to identify English-language studies published from 1980 to 2025 on NOM of abdominal solid organ injuries (ASOI) from blunt trauma (BT) in pediatric and adult patients, adhering to PRISMA guidelines.

The systematic review analyzed outcomes from 21 clinical studies that met the inclusion criteria, in contrast, nine studies only met the inclusion criteria for the meta-analysis assessment. This meta-analysis and systematic review validates that NOM of blunt ASOI is effective and safe in both children and adults.

Although NOM in adults is generally limited to lower-grade injury, children are frequently managed non-operatively for higher-grade injury, reflecting perhaps differences in injury pattern and clinical management considerations, despite overall very similar protocols being applied. The data of this study displayed also no statistically significant differences between children and adults regarding the other clinical parameters LOS, blood transfusion requirement, hemodynamic instability and mortality.