@article{ref1,
title="The spectrum and management of noniatrogenic vascular trauma in the pediatric population",
journal="Journal of pediatric surgery",
year="2018",
author="Kayssi, Ahmed and Metias, Maged and Langer, Jacob C. and Roche-Nagle, Graham and Zani, Augusto and Forbes, Thomas L. and Wales, Paul and King, Sebastian K.",
volume="53",
number="4",
pages="771-774",
abstract="BACKGROUND: To describe the spectrum of noniatrogenic pediatric vascular injuries and their outcomes at a large tertiary pediatric hospital. <br><br>METHODS: Retrospective review of a prospectively-maintained trauma database, identifying children with noniatrogenic vascular injuries managed between 1994 and 2014. <br><br>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. <br><br>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).<br><br>Copyright © 2017 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2017.04.015",
url="http://dx.doi.org/10.1016/j.jpedsurg.2017.04.015"
}