Kifayat Khan, Gohar Rehman, Mohammad Yunas Khan, Tariq Waheed.
Management of thoracic injuries in children.
J Postgrad Med Inst Jan ;18(1):18-23.

Objective: The aim of the study was to know the effective way of treatment and to sort out the measures for the prevention of various complications arising from thoracic injuries in children. Material and Methods: This is a prospective study performed on 173 children with thoracic injuries. Birth trauma was not included in this study. All these patients were received in emergency and were admitted to paediatric surgery unit of Lady Reading Hospital Peshawar during a period of 2 years from January 2000 to December 2001. Results: Blunt trauma (121 cases) was the most common cause of chest injuries seen in these children as compared to penetrating injuries (52 cases). All of them (156 cases) except lung contusion and chest wall injuries were treated with chest tube drainage and under waterseal. The clinical condition resulting from these chest injuries confirmed on X-ray chest were hemothorax (99 cases), haemopneumothorax (51 cases) and pneumothorax (6 cases). Cardiac injuries, great vessel injuries, esophageal injuries, tracheobronchial injuries, stove in and flail chest injuries were not encountered during the course of this study. There is no mortality from chest intubation in this study. There was no case of emergency thoracostomy however only 2 cases needed elective thoracotomies for complications after treatment with chest intubation. Conclusion: Emergency thoracostomy is a life saving procedure in all the clinical conditions resulting from thoracic trauma. Isolated chest injuries can be treated effectively by tube drainage of the chest on the affected side, which is safe, less traumatic and associated with least morbidity and no mortality.

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