Experiences in severe chest trauma of children in 20 years

Abstract

Though chest trauma in children is not so common as it is in adults, it may be life-threatening and suggest a high mortality. Herein we retrospected 59 cases of severe chest trauma of children out of 1506 chest trauma cases during 1986-2006 in our department. Features including demographic characteristics, causes, injury types, associated wound had been collected. There were 42 males (71.18%), 17 females (28.82%), 30 cases (50.84%) in the former 10 years and 29 cases (49.16%) in the latter 10 years. The incidence of children's severe chest trauma was 4.9% and 3.2%, respectively, averagely 3.9%. In these 59 cases, 46 cases were treated conservatively, 13 cases were treated by surgery. Four patients died, two in operations, the others attributed to ARDS and cardiac arrest, respectively. The cure rate was 93.22%. Statistic method was used to compare between two groups and with published results in the literature. Children's severe chest trauma is characteristic and different from adults. In our experience, accurate diagnoses and intensive care are very important to save their lives.

Traumatic chest injury in children: A single thoracic surgeon′s experience in two Nigerian tertiary hospitals

“…This may explain the findings from our study as rib fractures occurred more in children who were 10 years and above. These fractures were confirmed by simple chest roentgenograms and the lack of callus on subsequent chest roentgenogram[ 4 16 ] also further confirmed the absence of rib fracture after 2-3 weeks in the patients who did not have it.…”

“…Similarly, other previous reports from other parts of the world robustly noted that blunt chest injuries were high and ranged between 89.8% and 97.1% of all paediatric chest injuries. [ 1 2 4 7 8 ] However, a study done over 3 decades ago in the United States of American showed increased cases of penetrating injuries than blunt chest injuries. [ 9 ] This in actual fact is a deviation from the general findings.…”

“…[ 13 14 ] In China, traffic crashes were the predominant cause of children's chest trauma resulting to 56.6% of cases. [ 4 ] One can, therefore, state that the aetiology of paediatric chest injuries could result from by what is commonly present as the wounding object in a particular country. In our own case, the availability and accesses to trees and lack of space for recreational activities led to increased blunt chest injuries from falls.…”

“…Furthermore, the aetiology of chest injuries in children is different from that of adults; it is commonly caused by non-penetrating injuries such as automobile crashes and falls. [ 1 2 3 4 ]…”

“…Children have reduced functional residual capacity with higher oxygen consumption per unit body mass[ 5 ] thus the major complications of chest trauma in the early period is hypoxia. [ 4 ] Early diagnosis and treatment are imperative to prevent the death, which may result from chest injuries in children. [ 2 ]…”