Pediatric thoracic injuries-experience in a tertiary care centre

Abstract

Background: Isolated thoracic injury in children is not rare. Common modes of injury are blunt injury. As in children the chest wall is more compliant and the thickness of the subcutaneous and muscular layers is reduced, blunt trauma causes increased level of energy transmission leading to more chances of internal organ injuries whereas penetrating injury directly cause fatal injury to those vital organs causing significant mortality. In this study we are sharing our experience of managing isolated thoracic injuries in a tertiary trauma care centre with an encouraging outcome. Methods: This prospective study was conducted in the department of pediatric surgery in NRS medical college and hospital, Kolkata during January 2019 to December 2021. Results: Total no of cases with isolated thoracic injuries are 83 (Boys 50, girls 33). 64 children were treated conservatively and 19 required surgical intervention. 40% patients were between 2-6 years. Among the cases blunt trauma (82%), penetrating trauma (12%) and other mode of injuries (6%) have been noted which includes diaphragmatic rupture (2), bilateral hemothorax (2), unilateral hemothorax (10), pneumothorax (4), flail chest (2), isolated rib and clavicle injury (20), subcutaneous emphysema (4), tracheal injury (1), esophageal injury (1) and retained foreign body (3). Total 7 children required ventilatory support. Conclusions: Management of isolated thoracic injury is done mostly by conservative management and few require intercostal drain placement. Thoracotomy is required rarely. Postoperative ventillatory support is also an important factor for managing such patients.