Thoracic Trauma

Abstract

Thoracic injuries account for a minority of pediatric traumatic injuries but are significant for their related morbidity and mortality. Most are due to blunt trauma—motor vehicle collisions, motor-pedestrian collisions, and high-level falls—and do not require operative intervention. A thoracic injury in a child should alert the physician that significant blunt force energy was involved. Children have increased chest wall compliance; despite seemingly minor external findings, they can have a significant internal thoracic injury. Children are also at greater risk for the development of a tension pneumothorax and pulmonary contusion, which are the most common injuries and may be associated with rib fractures or hemothorax. Penetrating thoracic trauma has a higher mortality and is more common in older children and adolescents. Injuries to other areas of the thoracic cavity that are rare but can have a higher incidence of morbidity and mortality in children include injuries to the heart, great vessels, esophagus, tracheobronchial tree, thoracic duct, and diaphragm.