Blunt thoracic aortic injury in children |
| |
Authors: | Roy E Erb MD Sharon M Stein MD Murray J Mazer MD E Paul Nance Jr MD |
| |
Institution: | (1) Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 21st Avenue South and Garland, 37232-2675 Nashville, TN |
| |
Abstract: | Thoracic aortic injury (TAI) in children secondary to blunt chest trauma is rare and less well documented than TAI in adults.
To further establishe the incidence and radiographic manifestations of this severe injury, we reviewed our experimence with
TAI in children over an 8-year period.
We performed a computer search from the Trauma Registry at our level I trauma center for all cases of TAI among patients 16
years of age or younger who were admitted after sustaining blunt chest trauma between August 1984 and September 1992. We reviewed
our records of all thoracic aortograms performed on children for blunt trauma during this same time period. Indication for
angiography was determined by review of chest radiographs and medical records of all patients who underwent thoracic aortography.
We reviewed medical records and all available chest radiographs, computed tomography (CT) examinations, and thoracic aortograms
of children diagnosed with TAI.
Of 308 children admitted with blunt chest trauma, 26 (8.4%) underwent angiography to exclude aortic or great vessel injury.
Of these 26 patients, three (11.5%) were diagnosed with TAI, and one patient demonstrated a traumatic pseudoaneurysm of the
proximal left subclavian artery. The incidence of TAI among children who sustained blunt chest trauma was 1.0% in our series.
All three patients with TAI in our series were male, ages 10–12 (mean: 11 years). Chest radiographs on two of the patients
with TAI revealed mediastinal widening, ill-defined aortic outline, shift of the trachea and nasogastric tube, and depression
of the left main stem bronchus. The chest radiograph in one patient with TAI was technically inadequate. CT demonstrated abnormalities
in two patients. Angiographic findings were similar to those seen in adults.
TAI in children is rare, occurring in 1% of children sustaining blunt chest trauma in our series. Our findings support previous
reports that the plain film, CT, and angiographic findings with this injury resemble those found in adults. |
| |
Keywords: | Aortic injury Blunt trauma Children Computed tomography Angiography |
本文献已被 SpringerLink 等数据库收录! |
|