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Deep venous thrombosis in the pediatric trauma population: an unusual event: report of three cases

O H Grandas1, M Klar, M H Goldman

  • 1Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, USA.

The American Surgeon
|April 12, 2000
PubMed

Insights

Deep venous thrombosis (DVT) is rare in pediatric trauma patients. Routine screening is not recommended unless patients have prolonged immobility, venous interventions, or symptoms, with hematologic evaluation for diagnosed cases.

Area of Science:

  • Pediatric Medicine
  • Trauma Surgery
  • Hematology

Background:

  • Deep venous thrombosis (DVT) incidence is lower in children than adults.
  • Pediatric trauma patients share risk factors with adult trauma patients.
  • Understanding DVT risk in pediatric trauma is crucial for appropriate management.

Observation:

  • A review of 2746 pediatric trauma patients (1989-1997) identified only three cases of DVT.
  • DVT occurred in adolescents, affecting upper and lower extremities.
  • One patient had pulmonary embolism without confirmed DVT.

Findings:

  • Identified risk factors included venous system manipulations (shunts, central lines, medical antishock trousers).
  • Therapies involved anticoagulation (heparin, warfarin) and a vena cava filter in one case.
  • No DVT was observed in patients with closed head or spinal cord injuries without additional risk factors.

Implications:

  • The thrombotic risk in pediatric trauma patients is generally low.
  • Routine DVT screening or prophylaxis is not indicated for all pediatric trauma patients.
  • Targeted screening and hematologic evaluation are recommended for high-risk individuals and diagnosed cases.

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