Pediatric vs adult vascular trauma: a National Trauma Databank review

Surgical intervention in vascular trauma in children

“…[5] In contrast to other types of injury in childhood, where blunt trauma predominates, a significant proportion of vascular trauma in childhood is caused by a penetrating injury accounting for 10-20% of all paediatric trauma admissions in some centres [8]. In other studies, the upper extremity arteries were the most commonly injured with injuries of the aorta (thoracic or abdominal) being least common [6,9]. In the current study, only 6 of the 20 injuries (30%) reported in this study resulted from a penetrating wound, of which 2 resulted from gunshots.…”

“…One major difference between children and adults is that the children are still growing and developing and vascular trauma may potentially lead to problems in growth and development at a later stage. But in terms of mortality, however, paediatric patients appear to have a better outcome when compared to adults [6].…”

“…Although vascular concerns may quite frequently accompany orthopaedic injuries, direct trauma involving the blood vessels (vascular trauma) is much less common in childhood than in adults and is said to represent only 0.6% of all paediatric trauma [6]. Decisions about when to operate remain an unresolved issue.…”

Pediatric Vascular Injury

“…Although injury-prevention measures such as increased use of seat belts and child-safety seats have effectively reduced the death rate from unintentional injury in children, modern series indicate that vascular injuries still occur in 0.6% to 1% of pediatric trauma patients 1,2 which is comparable to the demographics of this problem decades ago. 2,3 Iatrogenic injuries represent a significant proportion of the pediatric vascular trauma managed in specialty centers across the United States because of an increase in percutaneous vascular access procedures in children.…”

“…This lends support to making an early diagnosis and to performing definitive repair as a viable management strategy. 1 This chapter is structured to address the multiple components of pediatric vascular injury from iatrogenic, penetrating, and blunt-traumatic etiologies. Herein, we will examine the scope of the problem, invasive and noninvasive diagnostic modalities, nonoperative management options, and open and endovascular treatments.…”