Chest trauma in children: A local experience

Background: Chest trauma in childhood is relatively uncommon in clinical pr actice, and has been the subject of few reports in the literature. This stu dy was undertaken to examine our experience in dealing with chest trauma in children. Patients and Methods: This was a retrospective study of 74 children who sus tained chest trauma, and were referred to King Fahad Hospital in Medina ove r a two-year period. The age, cause of injury, severity of injury, associat ed extrathoracic injuries, treatment and outcome were analyzed. Results: The median age of the patients was nine years. Fifty-nine of them (80%) sustained blunt trauma, and 15 (20%) were victims of penetrating inju ries. Road traffic accident was the cause of chest trauma in 62% of the chi ldren, gun shot wounds were seen in five, and stab wounds in 10 children. H ead injury was the most common injury associated with thoracic trauma, and was seen in 14 patients (19%), and associated intraabdominal injuries were seen in nine patients. Chest x-ray of the blunt trauma patients revealed fr actured ribs in 24 children, pneumothorax in six, hemothorax in four, hemop neumothorax in three, and pulmonary contusions in 22 patients. Fifty-one pe rcent of children were managed conservatively, 37% required tube thoracosto my, 8% were mechanically ventilated, and 4% underwent thoracotomy. Conclusion: The prevalence of chest trauma in children due to road traffic accidents is high in Saudi Arabia. Head injury is thought to be the most co mmon associated extrathoracic injuries, however, most of these patients can be managed conservatively.