TY  - JOUR
PY  - 2018//
TI  - The spectrum and management of noniatrogenic vascular trauma in the pediatric population
JO  - Journal of pediatric surgery
A1  - Kayssi, Ahmed
A1  - Metias, Maged
A1  - Langer, Jacob C.
A1  - Roche-Nagle, Graham
A1  - Zani, Augusto
A1  - Forbes, Thomas L.
A1  - Wales, Paul
A1  - King, Sebastian K.
SP  - 771
EP  - 774
VL  - 53
IS  - 4
N2  - 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>
LA  - en
SN  - 0022-3468
UR  - http://dx.doi.org/10.1016/j.jpedsurg.2017.04.015
ID  - ref1
ER  -