The spectrum and management of noniatrogenic vascular trauma in the pediatric population.

Autor: Kayssi A; Division of Vascular Surgery, University Health Network, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4., Metias M; Division of Vascular Surgery, University Health Network, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4., Langer JC; Division of General & Thoracic Surgery, Hospital for Sick Children, 555 University Avenue Toronto, ON, Canada M5G 1X8. Electronic address: jacob.langer@sickkids.ca., Roche-Nagle G; Division of Vascular Surgery, University Health Network, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4., Zani A; Division of General & Thoracic Surgery, Hospital for Sick Children, 555 University Avenue Toronto, ON, Canada M5G 1X8., Forbes TL; Division of Vascular Surgery, University Health Network, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4., Wales P; Division of General & Thoracic Surgery, Hospital for Sick Children, 555 University Avenue Toronto, ON, Canada M5G 1X8., King SK; Division of General & Thoracic Surgery, Hospital for Sick Children, 555 University Avenue Toronto, ON, Canada M5G 1X8.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2018 Apr; Vol. 53 (4), pp. 771-774. Date of Electronic Publication: 2017 Apr 29.
DOI: 10.1016/j.jpedsurg.2017.04.015
Abstrakt: Background: To describe the spectrum of noniatrogenic pediatric vascular injuries and their outcomes at a large tertiary pediatric hospital.
Methods: Retrospective review of a prospectively-maintained trauma database, identifying children with noniatrogenic vascular injuries managed between 1994 and 2014.
Results: A total of 198 patients were identified. Those patients with a digital or intracerebral vascular injury (92/198) were excluded from further analysis. The remaining 106 patients represented 1.2% of all traumas managed at our institution during the 21-year study period. The majority were male (75%), and between 1 and 12years of age (71% of all patients). Median time from trauma scene to any hospital was 48min (range 0-132), and most patients were transferred from another hospital (64%). Three patients were declared dead upon arrival (3%). Penetrating injuries accounted for most injuries (72%), while blunt injuries accounted for the remainder. Ulnar, radial, or brachial artery trauma accounted for 47% of injuries. Most vessels were treated operatively, by primary repair (49%), vessel ligation (15%), or interposition graft (12%). Fourteen patients (13%) were managed nonoperatively and most patients (74%) experienced no complications in hospital or during follow-up.
Conclusion: Noniatrogenic pediatric vascular injuries are rare and represent a highly heterogeneous population. Most children recover well, with minimal perioperative complications.
Level of Evidence: IV (case series with no comparison group).
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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