Pediatric penetrating neck trauma: Hard signs of injury and selective neck exploration

The Journal of Trauma and Acute Care Surgery
Rober A TesslerJames Betts

Abstract

Selective neck exploration and computed tomography angiography (CTA) in penetrating neck trauma have been well described in adults. However, data in the pediatric population are sparse. The extent to which these practices have been adopted in pediatric patients is unknown. Retrospective, single-center cohort study of pediatric penetrating neck trauma for the years 2001 to 2014 in a dedicated children's hospital/Level 1 pediatric trauma center. Clinical data, sensitivity and specificity of hard signs (active hemorrhage, airway compromise, expanding hematoma, crepitus, and so on) and soft signs of injury (bruit, voice change, stridor, laceration less than 2 cm, nonexpanding hematoma, and so on), and trends in imaging were examined. A total of 44 patients were identified with penetrating neck trauma. The majority of these patients were male (55%) aged 8 months to 18 years and a median of 7.3 years. Sixteen patients underwent neck exploration with 13 major injuries identified in 10 patients. Nineteen patients had associated injuries. Ten patients had at least one hard sign of injury, and 16 patients had only soft signs of injury. The sensitivity and specificity of hard signs of injury were 100% (95% confidence interval [CI], 59-100...Continue Reading

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Citations

May 17, 2019·BMJ Case Reports·Monica AbdelmasihGraham Roche-Nagle
Jul 21, 2020·The American Surgeon·Patrick D MelmerJason D Sciarretta
Dec 12, 2020·Annals of Surgical Treatment and Research·Ji Wool KoPil Young Jung
Mar 6, 2021·International Journal of Pediatric Otorhinolaryngology·Sam DeVictorMichele M Carr

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