The characteristics and outcomes of penetrating thoracic and abdominal trauma among children

Böleken, Mehmet Emin; Cevik, Muazez; Yağız, Beytullah; Ter, Mehmet; Dörterler, Mustafa Erman; Aksoy, T.

doi:10.1007/s00383-013-3339-z

Cited by 10 publications

(7 citation statements)

References 17 publications

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“…Thoracic injuries secondary to penetrating trauma are uncommon representing 25% of penetrating trauma in pediatrics. Male patients were the predominating gender which is consistent with published studies [4,9,12,13]. Moreover, Stab wound secondary to knives was the predominating MOI in our region as shown in numerous studies from other regions [4,9,13,15].…”

Section: Discussionsupporting

confidence: 91%

“…Male patients were the predominating gender which is consistent with published studies [4,9,12,13]. Moreover, Stab wound secondary to knives was the predominating MOI in our region as shown in numerous studies from other regions [4,9,13,15]. In the contrary, Schecter S et al showed that gunshot injuries were the most common MOI in pediatrics [21].…”

Section: Discussionsupporting

confidence: 90%

“…Among children, trauma is the most common cause of death [2]. Despite the fact that penetrating trauma is less frequent than blunt ones, penetrating injuries is associated with higher mortality regardless of age group [3][4][5]. Worldwide incidence of penetrating trauma varies from 10%-22% of all trauma cases [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Patterns of Pediatric Thoracic Penetrating Injuries: a Single Trauma Center Experience – Riyadh, Saudi Arabia

Alaqeel

Howsawi

Namshan

et al. 2020

Preprint

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Background Trauma in pediatric age group is a major cause of morbidity and mortality. The causes and magnitude of pediatric trauma differs from region to region. Many studies have focused on blunt injuries but not on penetrating trauma. Our aim is to identify the patterns, and outcome of pediatric thoracic penetrating injuries in a single trauma center. Methods We conducted a retrospective chart review of pediatric patients who presented with thoracic penetrating injuries from the year 2001 till 2016 in a level 1 trauma center. Patients aged 18 years or less who presented to our emergency department with thoracic penetrating injury were included. Those transferred from other institutions were excluded Results The total number of patients included with penetrating thoracic injuries were 89. Mean age was 15.5 years. One female the rest were males. The most common mechanism of injury is stab wound by knives in 80%, then Gunshot in 12%. Main mode of transport to emergency department was by private vehicles in 75.3%. Type of injuries sustained were pneumothorax 70.7%, hemothorax 25.8%, diaphragmatic injury 5.6%, hemopericardium 4.49%, lung contusion and laceration 7.8%, cardiac injury 4.49%, major vessel injury 3.4%, pneumomediastinum 2.2%, esophageal injury 1.1%, and rib Fractures 1.1%. In the emergency department, endotracheal intubation required in 13.5%, chest tube insertion 73%, blood transfusion for resuscitation 16.8%, emergency thoracotomy 2.2%, pericardiocentesis 1.1%. Surgical intervention was required in 17%. Mean length of hospital stay 3.87 days ± 4.86 SD. 93% of patients did not require intensive care unit admission. Mortality was observed in 3.4% were all had injuries to either heart, aorta or inferior vena cava. Conclusion In our institution, thoracic injuries were found uncommon and represent 25% of all penetrating trauma. Most sustained penetrating thoracic injuries can be managed nonoperatively safely. However, prompt resuscitation and intervention are required to identify and manage life-threatening ones.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

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Patterns of Pediatric Thoracic Penetrating Injuries: a Single Trauma Center Experience – Riyadh, Saudi Arabia

Alaqeel

Howsawi

Namshan

et al. 2020

Preprint

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“…5 The majority of the litera ture pertains to adult patients; however, CM has also been shown to be safe in children. 7 A 2012 Cochrane review 8 identified only 1 randomized controlled trial (RCT) 9 comparing operative to nonopera tive management for any type of abdominal trauma in hemodynamically asymptomatic patients. That 1996 RCT by Leppäniemi and Haapiainen 9 randomized 51 stable, asymptomatic patients without evisceration to either man datory laparotomy or observation.…”

mentioning

confidence: 99%

Conservative versus operative management in stable patients with penetrating abdominal trauma: the experience of a Canadian level 1 trauma centre

et al. 2016

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Background:The goal of conservative management (CM) of penetrating abdominal trauma is to avoid nontherapeutic laparotomies while identifying injuries early. Factors that may predict CM failure are not well established, and the experience of CM has not been well described in the Canadian context. Methods:We searched a Canadian level 1 trauma centre database for all penetrating abdominal traumas treated between 2004 and 2014. Hemodynamically stable patients without peritonitis and without clear indications for immediate surgery were considered potential candidates for CM, and were included in the study. We compared those who were managed with CM with those who underwent immediate operative management (OM). Outcomes included mortality and length of stay (LOS). Further analysis was per formed to identify predictors of CM failure.Results: A total of 72 patients with penetrating abdominal trauma were classified as potential candidates for CM. Ten patients were managed with OM, and 62 with CM, with 9 (14.5%) ultimately failing CM and requiring laparotomy. The OM and CM groups were similar in terms of age, sex, injury severity, mechanism and number of injur ies. There were no deaths in either group. The LOS in the intensive care (ICU)/trauma unit was 4.8 ± 3.2 days in the OM group and 2.9 ± 2.6 days in the CM group (p = 0.039). The only predictor for CM failure was intraabdominal fluid on computed tomography (CT) scan (odds ratio 5.3, 95% confidence interval 1.01-28.19). Conclusion:In select patients with penetrating abdominal trauma, CM is safe and results in a reduced LOS in the ICU/trauma unit of 1.9 days. Fluid on CT scan is a pre dictor for failure.Contexte : L'objectif du traitement conservateur des traumatismes abdominaux péné trants est d'éviter les laparotomies non thérapeutiques tout en ciblant rapidement les blessures. On n'a pas réussi à établir clairement des facteurs permettant de prédire la probabilité d'échec de ce type de traitement, ni bien décrit les paramètres d'utilisation de ce dernier dans le contexte canadien.

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“…Prehospital evaluation and assessment can predict the outcome of trauma patients. 6 , 7 Patients typically arrive at our ED without prior notification. Most of them arrive by their own vehicles.…”

Section: Discussionmentioning

confidence: 99%

Patterns of pediatric thoracic penetrating injuries

Alaqeel

Howsawi

Namshan

et al. 2021

SMJ

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Objectives: To review the patterns and outcomes of pediatric thoracic penetrating injuries in a level one trauma center. Methods: Retrospective chart review of pediatric patients who presented to the King Abdulaziz Medical City Emergency Department (KAMC-ED), Riyadh, Saudi Arabia with thoracic penetrating injury from 2001 to 2016. Results: Eighty-nine patients had a penetrating injury to the thorax were identified. The mean age was 15.5 ± 3.6 years. The mean length of hospital stay was 3.87 ± 5 days. The most common cause was stabbing followed by gunshot. Isolated injury to the thorax was seen in 58 patients. The most common injuries sustained were pneumothorax and hemothorax. In Original Article the ED, tube thoracostomy was required in 65 patients, endotracheal intubation in 12, blood transfusion in 14, massive blood transfusion in one, pericardiocentesis in one, and ED thoracotomy in 2. Only 15 patients required surgical intervention. The overall mortality rate was 3.4%. Death was mainly caused by associated injuries to the heart, aorta and/ or inferior vena cava. Conclusion: Thoracic injuries represent 25% of the overall penetrating traumas in pediatric age group. Most sustained injuries can be safely managed nonoperatively, with a favorable outcome. Prompt resuscitation and intervention are required to identify and manage life-threatening injuries.

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The characteristics and outcomes of penetrating thoracic and abdominal trauma among children

Abstract: The incidences of penetrating abdominal and thoracic trauma did not differ significantly. Penetrating injuries may be successfully managed by conservative therapy.

Cited by 10 publications

References 17 publications

Patterns of Pediatric Thoracic Penetrating Injuries: a Single Trauma Center Experience – Riyadh, Saudi Arabia

Patterns of Pediatric Thoracic Penetrating Injuries: a Single Trauma Center Experience – Riyadh, Saudi Arabia

Conservative versus operative management in stable patients with penetrating abdominal trauma: the experience of a Canadian level 1 trauma centre

Patterns of pediatric thoracic penetrating injuries

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