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Thoracic trauma in children
J P Rielly1, M L Brandt, K L Mattox
1Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, Texas.
Insights
This study analyzed 37 pediatric thoracic injuries over 15 years, finding blunt trauma more common, especially in young males involved in car crashes. Overall mortality was 25% for blunt trauma cases.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Thoracic Trauma
Background:
- Thoracic injuries in children are a significant cause of morbidity and mortality.
- Understanding the epidemiology and management of pediatric thoracic trauma is crucial for improving outcomes.
Purpose of the Study:
- To describe the characteristics, management, and outcomes of children admitted with thoracic injuries.
- To differentiate between blunt and penetrating thoracic trauma in a pediatric population.
Main Methods:
- Retrospective review of 37 pediatric patients admitted with thoracic injuries over a 15-year period.
- Analysis of injury mechanisms, demographics, injury patterns, interventions, and mortality.
- Categorization of injuries into blunt and penetrating trauma.
Main Results:
- Two-thirds of injuries were blunt trauma, predominantly in males aged 4-6 years, often from motor vehicle crashes.
- Penetrating trauma occurred in 35% of patients, with a higher median age (13 years) and a mix of stab and gunshot wounds.
- Overall mortality was 25% for blunt trauma; seven children died, six from motor vehicle accidents, four with head injuries.
Conclusions:
- Blunt thoracic trauma is more prevalent in younger children, often linked to motor vehicle accidents.
- Penetrating thoracic trauma affects older children and adolescents, with varied injury types.
- Prompt management, including thoracotomy and laparotomy when indicated, is vital, though overall mortality remains a concern.
Abstract:
Thirty-seven children were admitted for the treatment of thoracic injuries during a 15-year period. Two thirds suffered blunt trauma. Of these children with blunt injuries, three quarters were male, with a median age of 6 years. Half of all victims of blunt trauma were between the ages of 4 and 6 years, and most were involved in motor vehicle crashes. Thirteen children (35%) were victims of penetrating trauma. Sixty-nine percent were male. The median age was 13 years, with 9 of 13 patients in their teenage years. Injuries were evenly distributed between stab and gunshot wounds. Eight of the 37 patients (22%) required thoracotomy. Fourteen had associated intra-abdominal injuries. Twelve of these patients had injuries that required exploratory laparotomy and two were managed expectantly. There were 27 patients with lung injuries, three quarters of whom were managed with tube thoracostomy alone. Seven children suffered injuries that resulted in their deaths. Six had been struck by a motor vehicle. Four of these six died of closed head injuries. The overall mortality of patients with blunt trauma was 25%.