Four-year experience of paediatric penetrating injuries: findings from a paediatric major trauma centre in the UK

Abstract

To review the experience of penetrating injury and its subsequent imaging and to discuss imaging strategies in overall trauma management in a paediatric major trauma centre. A retrospective, single-centre study was conducted over a 4-year period (1/1/16-31/12/19) of children (<16 years old) presenting to the Emergency Department with penetrating trauma. Clinical, radiographic, and demographic data were analysed using descriptive statistics. Fifty-eight patients in >60 attendances were reviewed. Most (44/60, 73%) underwent some imaging, with almost half (28/60, 47%) having both computed tomography (CT) and radiography. Of cases with only a single injury site (35/60, 58%), CT was performed in 19/35 (54%) with 13/19 (68%) covering more than one body area. Of the multi-injury site cases (26/60, 42%), CT was performed in 16/25 (64%) with 14/16 (88%) involving multiple body areas. The most common injuries were solid-organ lacerations and soft-tissue and vascular injuries according to body site involved. Contrast-enhanced CT across multiple body parts should be performed for multiple stab wounds or visible injuries involving the torso. Isolated penetrating injuries may only require CT of a single body part unless the entry wound crosses body parts. An imaging algorithm is suggested, which may be applicable to other paediatric trauma units.