Penetrating cardiac trauma in children

BACKGROUND Penetrating cardiac traumas in children are dramatic and fatal. Many of the patients are admitted to hospital either in a state of shock or they are dead at presentation. In this study, we aimed to present our experience in penetrating cardiac trauma in children. METHODS Seventeen pediatric cases of penetrating cardiac trauma were retrospectively evaluated. The effects on the results of the demographic characteristics of patients, etiology of penetrating trauma, time of presentation to the hospital, physical examination findings in the emergency department, diagnostic methods used, and the surgical techniques applied were evaluated. RESULTS The male to female ratio of the 17 retrospectively evaluated cases was 16:1, with an age range of 3-15 years. The patients' mean age was 12.94 +/- 3.52 years. In all patients, the penetrating cardiac trauma was due to incisive/penetrating tools. The mean Ivatury physiologic index score was 8.23 +/- 0.78, whereas the mean cardiac injury organ scale score was 5.00 +/- 0.00. The hospital mortality rate was 5.9% due to the loss of one patient. CONCLUSION Shock may develop in pediatric penetrating cardiac trauma in a short time due to hemorrhage and/or cardiac tamponade. The prime factors for patient survival are early diagnosis and emergency thoracotomy.