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J Trauma Inj > Volume 29(2); 2016 > Article
Journal of Trauma and Injury 2016;29(2):37-42.
DOI: https://doi.org/10.20408/jti.2016.29.2.37    Published online June 30, 2016.
Peripheral Arterial Injuries in Pediatric Age Group
Ahmed A R Ammar
Department of Cardiovascular Surgery, Ibn Al-Bitar Center for Cardiac Surgery, Baghdad, Iraq.
Received: 12 April 2016   • Revised: 29 April 2016   • Accepted: 15 June 2016
Abstract
PURPOSE
Arterial injury in children is a challenging problem for its special characteristics. It is rare even during warfare. This review described a personal experience in the management and outcome of acute pediatric arterial injuries of extremities.
METHODS
Thirty-six children below age of 13 years were studied during period from 2004 through 2014 in Iraq.
RESULTS
Male patients were 27 (75%) and female were 9 (25%). Seven to twelve years old was the most affected age group. The incidence of iatrogenic injuries was greater in infants and toddlers while penetrating injuries were the most common in older children. Upper limbs arteries were affected in 17 (47.2%) and lower limb in 19 (52.8%) patients. Hard signs were the commonest mode of presentation (83.3%). Lateral wall tear and complete transection were the most frequent types of arterial injury (36.1% and 27.8% respectively). The most frequent procedures performed were end-to-end anastomosis and lateral arteriorrhaphy. Surgical outcome was good. In 27 cases distal pulsations were regained. Seven cases had impalpable distal pulses but still viable limbs. Limb length discrepancy was detected in one case. One case was complicated with limb loss. No death was recorded.
CONCLUSION
Arterial injuries in children are age related. The proper treatment of arterial injuries in children requires high index of suspicion, early operative intervention and continuous postoperative follow-up throughout years of active growth. Angiogram has a limited role as a diagnostic tool in acute arterial injuries.
Key Words: Pediatrics; Vascular system injuries; War-related injuries


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