Document Detail


Pediatric blunt trauma resulting in major arterial injuries.
MedLine Citation:
PMID:  15156954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ten children, aged 4 to 14 years, sustaining blunt arterial trauma from motor vehicle collisions (6), bicycle accidents (2), and falls (2) were identified over a 10-year period. The arteries injured included the common iliac (3), abdominal aorta (2), carotid (2), brachial (2), and the subclavian, renal, and femoral artery (1 each). One patient had three arterial injuries. Six patients had associated injuries including a pelvic and lumbar spine fracture, Horner's syndrome, liver laceration, skull fracture, open humerus fracture, small bowel serosal tear, and a brachial plexus injury. Definitive diagnosis was made using arteriography (6), computed tomography (CT) scan (2), and physical examination (2). The types of arterial injuries found included incomplete transection, complete transection with pseudo-aneurysm formation, traumatic arteriovenous (AV) fistulas, complete occlusion, and dissection. Repair was accomplished by hypogastric artery interposition or bypass grafting, synthetic grafting with polytetrafluoroethylene (PTFE), reverse saphenous vein grafting, or primary repair, depending on the circumstances. An AV fistula between the carotid artery and cavernous sinus was embolized. All grafts remained patent with exception of the aorto-renal bypass graft at follow-up ranging from 1 month to 3 years. The principles for repairing vascular injuries in children are slightly different than those in adults. Every effort should be made to use autogenous tissue such as the hypogastric artery or saphenous vein for repair if possible. If not, PTFE grafts can be used, although the long-term patency of these grafts in growing children is not known.
Authors:
Zvonimir L Milas; Thomas F Dodson; Richard R Ricketts
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  70     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-25     Completed Date:  2004-06-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  443-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Emory University, Atlanta, Georgia 30322, USA.
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MeSH Terms
Descriptor/Qualifier:
Accidental Falls / statistics & numerical data
Accidents, Traffic / statistics & numerical data
Adolescent
Age Distribution
Angiography
Arteries / injuries*
Bicycling / injuries,  statistics & numerical data
Biomechanics
Blood Vessel Prosthesis Implantation / adverse effects,  methods,  statistics & numerical data
Child
Child, Preschool
Female
Follow-Up Studies
Georgia / epidemiology
Hospitals, Pediatric
Humans
Iliac Artery / transplantation
Injury Severity Score
Male
Physical Examination
Polytetrafluoroethylene
Saphenous Vein / transplantation
Tomography, X-Ray Computed
Treatment Outcome
Wounds, Nonpenetrating / diagnosis,  epidemiology,  etiology,  surgery*
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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