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Surgical Reminiscence
July 1, 2004

The Genesis of Nonoperative Management of Penetrating Abdominal Trauma

Arch Surg. 2004;139(7):800-801. doi:10.1001/archsurg.139.7.800

As a general surgeon with a subspecialty in trauma, I thoroughly enjoyed the article "High Success With Nonoperative Management of Blunt Hepatic Trauma: the Liver is a Sturdy Organ,"1 in the May 2003 issue of ARCHIVES. Having attended numerous debates between the late Aubrey Maynard, MD, and Gerald Shaftan, MD, arguing the merits of operative vs nonoperative management of penetrating abdominal trauma (including hepatic), I thought a bit of surgical history relating the genesis of nonoperative management of abdominal trauma was in order. While I have no doubt that surgeons had tried this method even before the events of the story I will relate, I do believe that I am detailing the history of the first large-scale controlled study of this problem in a huge trauma center, the (at that time) more than 2200-bed Kings County Hospital in Brooklyn, NY.

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