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Overview of intrathoracic injuries in children

Author
Donna Reyes Mendez, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

Trauma is the leading cause of death in children. Thoracic injury typically occurs as the result of forceful mechanisms that also cause serious associated injuries. This topic will review clinical manifestations and initial management of intrathoracic injuries in children.

Injuries that occur commonly as the result of thoracic trauma include blunt cardiac injury, pneumothorax, hemothorax, pulmonary contusion, and rib fractures. These conditions are discussed separately:

(See "Cardiac injury from blunt trauma", section on 'Pediatric considerations'.)

(See "Initial evaluation and stabilization of children with thoracic trauma".)

(See "Pulmonary contusion in children".)

                       

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Literature review current through: Nov 2016. | This topic last updated: Wed Feb 17 00:00:00 GMT+00:00 2016.
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References
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  1. Cooper A, Barlow B, DiScala C, String D. Mortality and truncal injury: the pediatric perspective. J Pediatr Surg 1994; 29:33.
  2. Kadish H.. Thoracic trauma. In: Textbook of Pediatric Emergency Medicine, 5th, Fleisher GR, Ludwig S, Henretig FM. (Eds), Lippincott, Williams & Wilkins, Philadelphia 2006. p.1433.
  3. Jackimczyk K. Blunt chest trauma. Emerg Med Clin North Am 1993; 11:81.
  4. Thompson A Jr, Illescas FF, Chiu RC. Why is the lower torso protected in traumatic asphyxia? A new hypothesis. Ann Thorac Surg 1989; 47:247.
  5. Gorenstein L, Blair GK, Shandling B. The prognosis of traumatic asphyxia in childhood. J Pediatr Surg 1986; 21:753.
  6. Hurtado TR, Della-Giustina DA. Traumatic asphyxia in a 6-year-old boy. Pediatr Emerg Care 2003; 19:167.
  7. Heckman SR, Trooskin SZ, Burd RS. Risk factors for blunt thoracic aortic injury in children. J Pediatr Surg 2005; 40:98.
  8. Barmparas G, Inaba K, Talving P, et al. Pediatric vs adult vascular trauma: a National Trauma Databank review. J Pediatr Surg 2010; 45:1404.
  9. Sartorelli KH, Vane DW. The diagnosis and management of children with blunt injury of the chest. Semin Pediatr Surg 2004; 13:98.
  10. McGwin G Jr, Reiff DA, Moran SG, Rue LW 3rd. Incidence and characteristics of motor vehicle collision-related blunt thoracic aortic injury according to age. J Trauma 2002; 52:859.
  11. Trachiotis GD, Sell JE, Pearson GD, et al. Traumatic thoracic aortic rupture in the pediatric patient. Ann Thorac Surg 1996; 62:724.
  12. Anderson SA, Day M, Chen MK, et al. Traumatic aortic injuries in the pediatric population. J Pediatr Surg 2008; 43:1077.
  13. Lowe LH, Bulas DI, Eichelberger MD, Martin GR. Traumatic aortic injuries in children: radiologic evaluation. AJR Am J Roentgenol 1998; 170:39.
  14. Pabon-Ramos WM, Williams DM, Strouse PJ. Radiologic evaluation of blunt thoracic aortic injury in pediatric patients. AJR Am J Roentgenol 2010; 194:1197.
  15. Murala JS, Numa A, Grant P. Traumatic rupture of the aorta in children--stenting or surgical intervention? A word of caution. J Thorac Cardiovasc Surg 2006; 132:731.
  16. Goldstein BH, Hirsch R, Zussman ME, et al. Percutaneous balloon-expandable covered stent implantation for treatment of traumatic aortic injury in children and adolescents. Am J Cardiol 2012; 110:1541.
  17. Gunabushanam V, Mishra N, Calderin J, et al. Endovascular stenting of blunt thoracic aortic injury in an 11-year-old. J Pediatr Surg 2010; 45:E15.
  18. Keyhani K, Estrera AL, Safi HJ, Azizzadeh A. Endovascular repair of traumatic aortic injury in a pediatric patient. J Vasc Surg 2009; 50:652.
  19. Moore MA, Wallace EC, Westra SJ. The imaging of paediatric thoracic trauma. Pediatr Radiol 2009; 39:485.
  20. Nance ML, Branas CC, Stafford PW, et al. Nonintracranial fatal firearm injuries in children: implications for treatment. J Trauma 2003; 55:631.
  21. Balci AE, Kazez A, Eren S, et al. Blunt thoracic trauma in children: review of 137 cases. Eur J Cardiothorac Surg 2004; 26:387.
  22. Bliss D, Silen M. Pediatric thoracic trauma. Crit Care Med 2002; 30:S409.
  23. Han SY, McElvein RB, Aldrete JS, Tishler JM. Perforation of the esophagus: correlation of site and cause with plain film findings. AJR Am J Roentgenol 1985; 145:537.
  24. Pryor SD, Lee LK. Clinical outcomes and diagnostic imaging of pediatric patients with pneumomediastinum secondary to blunt trauma to the chest. J Trauma 2011; 71:904.
  25. Srinivasan R, Haywood T, Horwitz B, et al. Role of flexible endoscopy in the evaluation of possible esophageal trauma after penetrating injuries. Am J Gastroenterol 2000; 95:1725.
  26. Eroglu A, Can Kürkçüogu I, Karaoganogu N, et al. Esophageal perforation: the importance of early diagnosis and primary repair. Dis Esophagus 2004; 17:91.
  27. Balci AE, Eren N, Eren S, Ulkü R. Surgical treatment of post-traumatic tracheobronchial injuries: 14-year experience. Eur J Cardiothorac Surg 2002; 22:984.
  28. Gaebler C, Mueller M, Schramm W, et al. Tracheobronchial ruptures in children. Am J Emerg Med 1996; 14:279.
  29. Poli-Merol ML, Belouadah M, Parvy F, et al. Tracheobronchial injury by blunt trauma in children: is emergency tracheobronchoscopy always necessary? Eur J Pediatr Surg 2003; 13:398.
  30. Baumgartner F, Sheppard B, de Virgilio C, et al. Tracheal and main bronchial disruptions after blunt chest trauma: presentation and management. Ann Thorac Surg 1990; 50:569.
  31. Nakayama DK, Rowe MI. Intrathoracic tracheobronchial injuries in childhood. Int Anesthesiol Clin 1988; 26:42.
  32. Tack D, Defrance P, Delcour C, Gevenois PA. The CT fallen-lung sign. Eur Radiol 2000; 10:719.
  33. Brandt ML, Luks FI, Spigland NA, et al. Diaphragmatic injury in children. J Trauma 1992; 32:298.
  34. Ramos CT, Koplewitz BZ, Babyn PS, et al. What have we learned about traumatic diaphragmatic hernias in children? J Pediatr Surg 2000; 35:601.
  35. Karnak I, Senocak ME, Tanyel FC, Büyükpamukçu N. Diaphragmatic injuries in childhood. Surg Today 2001; 31:5.
  36. Barsness KA, Bensard DD, Ciesla D, et al. Blunt diaphragmatic rupture in children. J Trauma 2004; 56:80.
  37. Miller L, Bennett EV Jr, Root HD, et al. Management of penetrating and blunt diaphragmatic injury. J Trauma 1984; 24:403.
  38. Beauchamp G, Khalfallah A, Girard R, et al. Blunt diaphragmatic rupture. Am J Surg 1984; 148:292.
  39. Gelman R, Mirvis SE, Gens D. Diaphragmatic rupture due to blunt trauma: sensitivity of plain chest radiographs. AJR Am J Roentgenol 1991; 156:51.
  40. Blumenthal DH, Raghu G, Rudd TG, Herman CM. Diagnosis of right hemidiaphragmatic rupture by liver scintigraphy. J Trauma 1984; 24:536.
  41. Waldschmidt ML, Laws HL. Injuries of the diaphragm. J Trauma 1980; 20:587.
  42. Payne JH Jr, Yellin AE. Traumatic diaphragmatic hernia. Arch Surg 1982; 117:18.
  43. Stark P, Jacobson F. Radiology of thoracic trauma. Curr Opin Radiol 1992; 4:87.
  44. Brown PF 3rd, Larsen CP, Symbas PN. Management of the asymptomatic patient with a stab wound to the chest. South Med J 1991; 84:591.