Introduction: the peripheral vascular trauma in the pediatric population constitutes a major challenge, because of their relatively low incidence and the anatomical characteristics of this population.The aim of this study is to describe and to analyze the epidemiological data, the diagnostic and the therapeutic mdalities a well as the evolution’s particularies of these injuries, before comparing the results of our study with the data of the literature. This, to clarify the intersections and the differences, and to codify the principles of care of this.
Materials and methods: our study is a descriptive and analytical retrospective review, realized in the service of vascular surgery of AL FARABI hospital of Oujda about 8 cases of vascular trauma of the extremities at the child and the teenager, between January, 2009 and July, 2014.The data of the patients included the epidemiological data, the mechanism, the clinical profile of admission, the vessel involved, the realization or not of a complementary exploration, the injuries associated as well as the surgical management and the evolution.
Results: the average age of our patients was: 12 years (18 months -16 years), with a net male ascendancy (100 %). The trauma were penetrating in 7 cases (87.5 %),among which 5 cases by glass wound and 2 cases by bladed weapon (25 %). Whereas the blunt trauma was present at a single case. The lower limb was the most affected (63 %), the most affected vessels were, the radial artery ( 2 cases) and the popliteal artery ( 2 cases), then the brachial artery ( 1 case), the anterior tibial artery ( 1 case) the posterior tibial artery ( 1 case) the popliteal vein ( 1 case).The clinical presentation in urgency forms was dominated by the hemorrhagic (37 %) and ischemic syndromes (25 %). For the chronic forms, they consisted on 3 pseudoaneurysm. During our study the arterial echo-doppler was performed for 3 patients, Angioscanner, to 1 only patient and the arteriography to 1 only case. The surgical operation was mainly the interposition of a venous bypass which was practiced at 4 cases (50 %), the termino-terminal suture in 3 cases (37.5 %), 1 only patient benefited from a direct suture of a side wound.The short-term evolution was favorable for all our patient, a single case guarded neurological deficit (hypoesthesia)
Conclusion: the care of the vascular trauma of the extremities at the child and the teenager knew big progress as for the diagnostic and therapeutic ways which have for objective: the revascularization of the limb and the stop of the bleeding on which depend respectively the functional and life-threatening