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Penetrating thermal vascular injury in a child: a case report
J W McNeil1, W O Thomas, A Luterman
1Division of Plastic and Reconstructive Surgery, University of South Alabama Medical School, Mobile.
Insights
Pediatric penetrating vascular trauma requires specialized care, focusing on limb growth and long-term graft patency. This case highlights managing a complex external iliac artery and vein injury in a child.
Area of Science:
- Vascular Surgery
- Pediatric Trauma Care
- Reconstructive Surgery
Background:
- Penetrating vascular trauma in children presents unique challenges compared to adults.
- Common causes include wartime injuries and invasive imaging complications.
- Treatment must address symmetric limb growth and long-term graft patency.
Observation:
- A 5-year-old child sustained a penetrating thermal injury to the distal external iliac artery and vein from a hot metal pipe.
- This injury necessitated complex surgical intervention.
Findings:
- The report details the management of this rare pediatric vascular injury.
- Key considerations included conduit selection, extraanatomic reconstruction, anastomotic technique, and soft tissue coverage.
Implications:
- Successful management ensures proper limb development and graft function in pediatric patients.
- This case provides insights into optimizing outcomes for severe vascular trauma in children.
Abstract:
Penetrating vascular trauma in children is most commonly seen in wartime settings or more recently as a result of attempts at invasive imaging. Treatment of these patients can be more complicated than treatment of trauma in adults and must include maintenance of symmetric limb growth, compensatory growth of the vascular graft and its anastomoses, and the need for very long-term graft patency. This report describes the care of a 5-year-old child who was impaled by a hot metal pipe and sustained a penetrating thermal injury to the distal external iliac artery and vein. Issues such as conduit choice, extraanatomic reconstruction, anastomotic suture technique, and soft tissue coverage are reviewed in the report.
