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A traumatic asphyxia in a child
1Department of Anesthesiology, The University of Tokyo, Faculty of Medicine, Japan. nishiyam@ims.u-tokyo.ac.jp
Insights
Traumatic asphyxia in children is rare. A 3-year-old boy recovered fully without specific treatment despite severe chest and abdominal compression from a vehicle.
Area of Science:
- Pediatric Traumatology
- Emergency Medicine
Background:
- Traumatic asphyxia is uncommon in children, with distinct pathophysiology compared to adults.
- Severe thoraco-abdominal compression can lead to significant clinical manifestations.
Observation:
- A 3-year-old boy sustained severe compression from a vehicle's tire.
- Clinical presentation included lethargy, cyanosis, petechiae, facial edema, and elevated liver enzymes.
- Initial assessment revealed no severe brain, ocular, thoracic, or abdominal injuries.
Findings:
- The child's cyanosis resolved within hours.
- Petechiae gradually disappeared over several days.
- The patient recovered without complications and was discharged on day 13.
Implications:
- This case highlights the potential for recovery in pediatric traumatic asphyxia, even with severe compression.
- It underscores the importance of close monitoring and supportive care in such rare pediatric emergencies.
- Further research into the specific pathophysiology and management of traumatic asphyxia in children is warranted.
Purpose:
Traumatic asphyxia in a child is rare and the pathophysiology is different from that occurring in an adult. We report a case of traumatic asphyxia in a child who recovered without specific treatment, even though chest and abdominal compression was severe.
Clinical Features:
A three-year-old boy (14.2 kg) was run over by the rear wheel of a Jeep. He was under the tire for about three minutes and then was transferred to our hospital. When he arrived, he was lethargic with Glasgow Coma Scale of E3V4M6 (coma score of 13). He was cyanotic in his face and had a tire mark from the left shoulder to the right abdomen, petechiae on the head, face, conjunctiva and chest, oral bleeding, and facial edema. Serum concentrations of liver enzymes were increased and microhematuria was detected. However, no injuries were seen in the brain, eye, chest, or abdomen. Cyanosis disappeared in a few hours. Facial and thoracic petechiae disappeared in three days and that of the conjunctiva in five days. He was discharged from hospital on the 13th day without any disturbances.
Conclusion:
We present a three-year-old boy with traumatic asphyxia. He had no complications although he received severe thoraco-abdominal compression by a Jeep.