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Arterial Injuries in Children

Arterial Injuries in Children Abstract • Twenty-nine children sustained major arterial injuries secondary to gunshot wounds (nine), blunt injuries (11), penetrating injuries by sharp objects (five), and arteriographic injury (four). The femoral artery was most commonly injured, followed by the brachial, the carotid, subclavian, popliteal, aorta, innominate, and vertebral arteries. We repaired the majority of the arterial injuries by resecting the damaged vessel, with primary anastomosis or interposition grafting when necessary to avoid tension. Postoperative complications included clotted grafts in two patients, which were rendered patent by reoperation. Two children died postoperatively, although both had successful vascular repairs. All vascular repairs were patent at one year, and limb length disparity has occurred in one patient following a nerve injury. Our data indicate that early exploration and repair of all suspected vascular injuries can be accomplished with excellent results, even in young children. (Arch Surg 1981;116:685-690) References 1. Bloom JD, Mozersky DJ, Buckley CJ, et al: Defective limb growth as a complication of catheterization of the femoral artery . Surg Gynecol Obstet 1974;138:524-526. 2. Whitehouse WM, Coran AG, Stanley JC, et al: Pediatric vascular trauma . Arch Surg 1976;111:1269-1275.Crossref 3. Moore TC, Peter M: Thru-and-thru gunshot penetration of distal abdominal aorta in a 4-year-old child managed by aortic transection, debridement, and reanastomosis with survival . J Trauma 1979;19:537-539.Crossref 4. Meagher DP, Defore WW, Mattox KL, et al: Vascular trauma in infants and children . J Trauma 1979;19:532-536.Crossref 5. Quinby WC: Fractures of the pelvis and associated injuries in children . J Pediatr Surg 1966;1:353-364.Crossref 6. Schwartz DL, Haller JA: Open anterior hip dislocation with femoral vessel transection in a child . J Trauma 1974;14:1054-1059.Crossref 7. White JJ, Talbert JL, Haller JA: Peripheral arterial injuries in infants and children . Ann Surg 1968;167:757-766.Crossref 8. Wholey MD, Bocher J: Angiography in musculoskeletal trauma . Surg Gynecol Obstet 1967;125:730-736. 9. Gratz RR: Accidental injury in childhood: A literature review on pediatric trauma . J Trauma 1979;19:551-555.Crossref 10. Rang M: Fractures with vascular damage , in Children's Fractures . Philadelphia, JB Lippincott Co, 1974, p 29. 11. Peacock JB, Proctor JH: Factors limiting extremity function following vascular injury . J Trauma 1977;17:532-535.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Arterial Injuries in Children

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References (13)

Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1981.01380170157028
Publisher site
See Article on Publisher Site

Abstract

Abstract • Twenty-nine children sustained major arterial injuries secondary to gunshot wounds (nine), blunt injuries (11), penetrating injuries by sharp objects (five), and arteriographic injury (four). The femoral artery was most commonly injured, followed by the brachial, the carotid, subclavian, popliteal, aorta, innominate, and vertebral arteries. We repaired the majority of the arterial injuries by resecting the damaged vessel, with primary anastomosis or interposition grafting when necessary to avoid tension. Postoperative complications included clotted grafts in two patients, which were rendered patent by reoperation. Two children died postoperatively, although both had successful vascular repairs. All vascular repairs were patent at one year, and limb length disparity has occurred in one patient following a nerve injury. Our data indicate that early exploration and repair of all suspected vascular injuries can be accomplished with excellent results, even in young children. (Arch Surg 1981;116:685-690) References 1. Bloom JD, Mozersky DJ, Buckley CJ, et al: Defective limb growth as a complication of catheterization of the femoral artery . Surg Gynecol Obstet 1974;138:524-526. 2. Whitehouse WM, Coran AG, Stanley JC, et al: Pediatric vascular trauma . Arch Surg 1976;111:1269-1275.Crossref 3. Moore TC, Peter M: Thru-and-thru gunshot penetration of distal abdominal aorta in a 4-year-old child managed by aortic transection, debridement, and reanastomosis with survival . J Trauma 1979;19:537-539.Crossref 4. Meagher DP, Defore WW, Mattox KL, et al: Vascular trauma in infants and children . J Trauma 1979;19:532-536.Crossref 5. Quinby WC: Fractures of the pelvis and associated injuries in children . J Pediatr Surg 1966;1:353-364.Crossref 6. Schwartz DL, Haller JA: Open anterior hip dislocation with femoral vessel transection in a child . J Trauma 1974;14:1054-1059.Crossref 7. White JJ, Talbert JL, Haller JA: Peripheral arterial injuries in infants and children . Ann Surg 1968;167:757-766.Crossref 8. Wholey MD, Bocher J: Angiography in musculoskeletal trauma . Surg Gynecol Obstet 1967;125:730-736. 9. Gratz RR: Accidental injury in childhood: A literature review on pediatric trauma . J Trauma 1979;19:551-555.Crossref 10. Rang M: Fractures with vascular damage , in Children's Fractures . Philadelphia, JB Lippincott Co, 1974, p 29. 11. Peacock JB, Proctor JH: Factors limiting extremity function following vascular injury . J Trauma 1977;17:532-535.Crossref

Journal

Archives of Surgery – American Medical Association

Published: May 1, 1981

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