Ahmed Mousa1, Ossama M Zakaria2, Ibrahim Hanbal3, Tamer A Sultan4, Amr M El-Gibaly5, Mohamed Y Zakaria3, Mohammed A Nasr6, Bosat E Bosat7, Alaa Sharabi3, Mohamed Neinaa8, Mohamed Abd El-Hamid3, Mohamed Y Daoud8, Mahsoub M Amin3, Ahmed M Odeh8, Omer M Alhaieg3, Mohamed A Farhan9, Mohamed Bubshait8, Abdul Rahman S Al-Mulhim8. 1. Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt; Divisions of Vascular Surgery, Pediatric Surgery, Emergency Medicine, General Surgery, Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. Electronic address: isvascular@yahoo.com. 2. Divisions of Vascular Surgery, Pediatric Surgery, Emergency Medicine, General Surgery, Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia; Divisions of Pediatric Surgery, Emergency Surgery, Department of General and Emergency Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. 3. Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt. 4. Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt. 5. Department of General, Visceral, Thoracic and Vascular Surgery, Hanse Klinikum Stralsund, University Medicine of Greifswald, Germany. 6. Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt. 7. Department of General Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. 8. Divisions of Vascular Surgery, Pediatric Surgery, Emergency Medicine, General Surgery, Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. 9. Divisions of Pediatric Surgery, Emergency Surgery, Department of General and Emergency Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Abstract
OBJECTIVES: To evaluates the management and outcome of non-iatrogenic pediatric and adolescence extremity arterial injuries in a resource-challenged setting. METHODS: A retrospective study of the surgical management for non-iatrogenic extremity arterial trauma in pediatric and adolescence during the period from January 2008 to December 2015. This study was performed in two different countries at tertiary referral university and teaching hospitals having a specialized emergency and trauma centers. A thorough study of each patient record was collected from these centers including, the original demographic data and their clinical presentations. Operative data of each patient was also reported. RESULTS: During the 8-year period of the study, 149 pediatric and adolescent extremity arterial trauma patients were treated. They were 93.3% male, and 6.7% female, respectively. The age ranged from 2 to 18 years with a mean of 10.25 ± 4.05 years. Lower extremity arterial trauma was recorded in 51%, while 49% were having upper extremity injuries. Primary repair with end-to-end vascular anastomosis was performed in 51.7%, while an interposition reversed saphenous vein graft was performed in 48.3%. The operative procedures were performed by an experienced vascular surgeon and well-trained pediatric surgeons and general surgeons. Pseudoaneurysms was recorded in 9% of cases. Fasciotomy was performed in 15% of cases. CONCLUSION: Treatment of pediatric and adolescent extremity arterial injuries with primary end-to-end vascular anastomoses or with the use of an interposition reversed saphenous vein graft is a reliable, feasible, and more cost-effectiveness technique with good results. Moreover, it should be adopted for all vascular trauma patients, whenever possible.
OBJECTIVES: To evaluates the management and outcome of non-iatrogenic pediatric and adolescence extremity arterial injuries in a resource-challenged setting. METHODS: A retrospective study of the surgical management for non-iatrogenic extremity arterial trauma in pediatric and adolescence during the period from January 2008 to December 2015. This study was performed in two different countries at tertiary referral university and teaching hospitals having a specialized emergency and trauma centers. A thorough study of each patient record was collected from these centers including, the original demographic data and their clinical presentations. Operative data of each patient was also reported. RESULTS: During the 8-year period of the study, 149 pediatric and adolescent extremity arterial traumapatients were treated. They were 93.3% male, and 6.7% female, respectively. The age ranged from 2 to 18 years with a mean of 10.25 ± 4.05 years. Lower extremity arterial trauma was recorded in 51%, while 49% were having upper extremity injuries. Primary repair with end-to-end vascular anastomosis was performed in 51.7%, while an interposition reversed saphenous vein graft was performed in 48.3%. The operative procedures were performed by an experienced vascular surgeon and well-trained pediatric surgeons and general surgeons. Pseudoaneurysms was recorded in 9% of cases. Fasciotomy was performed in 15% of cases. CONCLUSION: Treatment of pediatric and adolescent extremity arterial injuries with primary end-to-end vascular anastomoses or with the use of an interposition reversed saphenous vein graft is a reliable, feasible, and more cost-effectiveness technique with good results. Moreover, it should be adopted for all vascular traumapatients, whenever possible.