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Pediatric penetrating thoracic trauma: a five-year experience

R J Peterson1, A D Tiwary, N Kissoon

  • 1Department of Surgery, University of Florida Health Science Center, Jacksonville 32209.

Pediatric Emergency Care
|June 1, 1994
PubMed

Insights

Pediatric penetrating thoracic trauma often requires surgery, unlike in adults. A thorough search for operative lesions is crucial in children with this type of injury, with many being preventable.

Area of Science:

  • Trauma Surgery
  • Pediatric Surgery
  • Thoracic Trauma Management

Background:

  • Adults with penetrating thoracic trauma are nonoperatively managed in 85% of cases.
  • Pediatric penetrating thoracic trauma may cause more vital tissue damage and necessitate operative intervention.
  • A level one trauma center's experience with pediatric penetrating thoracic trauma was analyzed.

Purpose of the Study:

  • To investigate the hypothesis that pediatric penetrating thoracic trauma leads to proportionately more vital tissue damage and a higher rate of operative intervention compared to adults.
  • To analyze the circumstances, interventions, and outcomes of pediatric penetrating thoracic trauma.
  • To determine the likelihood of surgical intervention in children with penetrating thoracic trauma.

Main Methods:

  • Retrospective analysis of pediatric penetrating thoracic trauma cases over a five-year period.
  • Data reviewed included injury circumstances, Pediatric Trauma Score (PTS), interventions, and outcomes.
  • Comparison of surgical intervention rates based on PTS.

Main Results:

  • Out of 61 children with thoracic trauma, 13 sustained penetrating injuries.
  • Seven patients (54%) underwent thoracotomy or laparotomy.
  • All five patients with a PTS < 8 required surgery, versus two of eight patients with a PTS > or = 8 (P < 0.05).

Conclusions:

  • Children with penetrating thoracic trauma are more likely to require surgical intervention than adults.
  • Penetrating thoracic trauma in children warrants a thorough search for operative lesions.
  • Approximately half of these pediatric thoracic trauma injuries are unintentional and potentially preventable.

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