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Clinical profile of thoracic trauma in children--a study from Aligarh, N. India
M H Beg1, M M Ansari, Reyazuddin
1Department of General Surgery, J.N. Medical College, A.M.U., India.
Insights
Blunt thoracic trauma in children, often from animal-related incidents in developing nations, frequently results in hemothorax or pneumothorax. Most cases were successfully treated with intercostal tube drainage, achieving a high success rate.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Public Health in Developing Countries
Background:
- Thoracic trauma in children presents unique challenges.
- Understanding the epidemiology and common causes of pediatric chest injuries is crucial for effective management.
- Developing countries face specific injury patterns due to prevalent agricultural practices and animal interactions.
Purpose of the Study:
- To analyze the characteristics, management, and outcomes of pediatric thoracic trauma cases.
- To identify the primary causes and common injury types in this patient population.
- To evaluate the efficacy of different treatment modalities and overall success rates.
Main Methods:
- Retrospective analysis of 60 pediatric thoracic trauma cases treated over 4.5 years.
- Categorization of injury mechanisms, focusing on blunt trauma and specific causes like animal-related injuries.
- Review of clinical presentations, diagnostic findings, treatment interventions (intercostal tube drainage, surgery, observation), and patient outcomes.
Main Results:
- Blunt trauma was the predominant cause (58.33%), with bullock-cart accidents and animal-horn/hoof injuries being significant contributors in developing regions.
- Hemothorax and/or pneumothorax were the most frequent injuries (78.33%).
- A high success rate of 96.67% was achieved, with most patients treated via intercostal tube drainage; major surgery was required in 30%.
Conclusions:
- Pediatric thoracic trauma, particularly from blunt mechanisms and animal-related incidents, requires prompt and appropriate management.
- Intercostal tube drainage is an effective primary treatment for many pediatric chest injuries.
- The study highlights the ongoing relevance of specific injury mechanisms in developing countries and demonstrates a high success rate in managing these cases.
Abstract:
A total of 60 cases of thoracic trauma in children, treated over a period of 4.5 years (January 1983 to June 1987), were analysed. Blunt-impact trauma was the major cause in 58.33% cases, stressing that bullock-cart accidents and bull-horn and buffalo-hoof injuries are still a continuing cause of chest injury in developing countries. Haemo- and/or pneumothorax were the main injuries (78.33%), but cardiac and oesophageal involvement were seen, in two cases each. Isolated first rib fracture was another surprising finding. Except for three, all the cases presented within 24 h of injury. Cyanosis and profound shock were found in five patients each. The majority of the patients (60%) were treated with intercostal tube drainage and major surgical operations were needed in 30%. In the remaining 10%, observation was sufficient. There were two deaths (3.33%), with a success rate of 96.67%.
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