Blunt thoracic trauma in children: review of 137 cases

Balcı, Akın Eraslan; Kazez, Ahmet; Eren, Sevval; Ayan, Erhan; Özalp, Koray; Eren, Mehmet Nesimi
August 2004
European Journal of Cardio-Thoracic Surgery;Aug2004, Vol. 26 Issue 2, p387
Academic Journal
thoracic Objective: Thoracic injuries are uncommon in children and few report present on blunt ones. Methods: Between 1994 and 2003, 137 children with blunt thoracic injury were reviewed. Results: The mean age of children was 6.9±7.3 (1–16) years. Etiology was falls in 46.7%, traffical accidents in 51% and abuse in 2.2%. Average height in fallen-down cases was 6.4±2 (range: 3–11) m. Calculated mean kinetic energy transfer to body was 1923±1056 J. When first seen, 70% (82/117) of the patients had vital signs that were within normal limits. Forty-two (35.9%) children had isolated thoracic injury. Associated injuries were present in 75 (64.1%) children. Head injury was the most common associated injury present in 33 (28.2%). Pulmonary contusion was the most common thoracic injury with 68 (49.6%). Seventeen (12.4%) required surgery, 11 (8%) of them were thoracic (4 for diaphragmatic tear, 2 for flail chest, 2 for tracheobronchial injuries, 2 for laceration, 1 for esophageal rupture). Surgical group had higher ISS (26.8 vs 36.2, P=0.001). Fifteen were lost (10.9%): There were lethal injuries in 7; chest tube treatment in 3; intensive care unit management in 2; mechanical support in 2 and observation in 1 patient. No death occurred for operations. Mortality rate was the lowest at injuries to chest alone and the highest for multi-system injuries (P<0.05). The hospital length of stay for averaged 13.4±8.8 (range: 4–49) days. Conclusion: Associated injury is the most important mortality factor. Thoracic operations can be performed with minimal morbidity and without mortality in children with blunt thoracic trauma.


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