Oh. Grandas et al., Deep venous thrombosis in the pediatric trauma population: an unusual event: Report of three cases, AM SURG, 66(3), 2000, pp. 273-276
The incidence of deep venous thrombosis (DVT) in the pediatric population h
as been reported to be lower than in adults. Pediatric trauma patients have
predisposing risk factors for DVT similar to those in the general trauma p
opulation, We reviewed the records of 2746 children under 16 years of age a
dmitted to our Level I pediatric trauma service from 1989 to 1997. Only thr
ee cases of DVT were documented, all adolescents. DVT was located in the up
per (n = 1) and lower (n = 1) extremity venous system. One patient presente
d with pulmonary embolism alone without identifiable DVT. Risk factors foun
d were venous system manipulations, including atriocaval shunt, subclavian
central line, and hyperinflated medical antishock trousers garment. Therapy
consisted of heparin followed by warfarin anticoagulation, A vena cava fil
ter was inserted in one patient for whom systemic anticoagulation was contr
aindicated, No DVT was seen in 1123 closed head injury patients or 29 spina
l cord injury patients without associated risk factors, The thrombotic risk
in pediatric trauma patients is low. Routine screening or prophylaxis is n
ot indicated except for patients who are likely to remain immobile for an e
xtended period of time and require prolonged rehabilitation, have venous ma
nipulations, or present with clinical symptoms. Hematologic evaluation in p
atients with diagnosed DVT is necessary to identify individual risk factors
.