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.
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
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.
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.