Traumatic Great Vessel Injuries In Children: A 10-Year Experience Of A Pediatric Intensive Care Unit In A Tertiary Hospital Center.

BACKGROUND

Traumatic injuries of the great vessels are rare but life-threatening in most cases. Road traffic crashes are the main cause of preventable traumatic injuries in Europe, namely great vessel injuries. Management of this condition in the pediatric population is poorly established and documented. We present our experience in assisting traumatic patients with traumatic great vessel injuries at a tertiary center Pediatric Intensive Care Unit. We also reviewed the approaches and clinical outcomes reported in the literature on behalf of this case series.

METHODS

We conducted a retrospective review of traumatic injuries reported from 2012 to 2021 at our Pediatric Intensive Care Unit. Patients under 18 years old who were victims of traumatic great vessel injuries were selected. Demographic and clinical data from these patients were collected until September of 2025 and analyzed.

RESULTS

Of the 260 trauma patients admitted to the Pediatric Intensive Care Unit, there were 4 (1.5%) cases of traumatic great vessel injuries associated with trauma. Three patients (75%) were male, and the mean age was 15.5 ± 1.7 years (range 13-17). The mechanism of trauma was blunt thoracoabdominal trauma from road traffic crashes in 3 patients and an abdominal stab wound due to aggression in 1 patient. The mean Modified Injury Severity Score and standard deviation were 15.5 ± 0.9. All patients required emergent surgery at hospital admission. The mean PICU stay and standard deviation were 24.7 ± 7.8 days. The median follow-up period was 71 (51-158) months. No major vessel complications or deaths were identified.

CONCLUSION

Traumatic great vessel injuries are rare, severe, and difficult to diagnose in children; however, early recognition and treatment are essential to improve survival. Prevention of trauma resulting from high-speed accidents and domestic violence among adolescents must be promoted by healthcare services, as well as by authorities and social and political entities.