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Torso vascular trauma.

Lauren L Evans1, Shahram Aarabi2, Rachelle Durand3

  • 1Division of Pediatric Surgery, UCSF Benioff Children's Hospitals, Department of Surgery, University of California San Francisco, San Francisco, CA 94611, USA.

Seminars in Pediatric Surgery
|December 21, 2021
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Summary

Pediatric torso vascular trauma requires prompt recognition and management. This review covers open and endovascular options for chest and abdominal vascular injuries in children, emphasizing surgical skills.

Keywords:
Abdominal injuriesArteriesBalloon occlusionChildEndovascular proceduresPediatricsThoracic injuriesVascular surgical proceduresVascular system injuriesWounds and injuriesWounds, NonpenetratingWounds, Penetrating

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Area of Science:

  • Pediatric Surgery
  • Vascular Surgery
  • Trauma Surgery

Background:

  • Vascular injuries in the chest and abdomen are rare but life-threatening in children.
  • These injuries demand specialized knowledge and skills from pediatric surgeons, especially in freestanding children's hospitals.
  • Hemorrhage and ischemia are critical complications of pediatric torso vascular trauma.

Purpose of the Study:

  • To provide a comprehensive overview of torso vascular trauma in pediatric patients.
  • To emphasize rapid recognition and management strategies for these injuries.
  • To discuss both open and endovascular treatment modalities.

Main Methods:

  • Review of literature on pediatric torso vascular trauma.
  • Discussion of specific injuries: mediastinal, subclavian, abdominal aorta, visceral, vena cava, and pelvic vasculature.
  • Analysis of open surgical techniques, damage control options, and endovascular interventions.

Main Results:

  • Covers blunt and penetrating injuries to major thoracic and abdominal vessels.
  • Details operative exposures, repair techniques, and damage control strategies like preperitoneal packing.
  • Evaluates endovascular options including stent grafts, angioembolization, and resuscitative endovascular balloon occlusion of the aorta (REBOA).

Conclusions:

  • Effective management of pediatric torso vascular trauma relies on prompt diagnosis and a combination of open and endovascular approaches.
  • Maintaining surgical expertise is crucial for pediatric surgeons managing these complex injuries.
  • Endovascular techniques offer valuable, albeit limited, options in specific pediatric vascular trauma scenarios.