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Besonderheiten von Gefäßverletzungen im Kindesalter

Characteristic features of vascular trauma in childhood

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Zusammenfassung

Gefäßverletzungen bei Kindern und Jugendlichen erfordern besonderes technisches Können hinsichtlich der Versorgung kleiner Gefäße, die zum Spasmus neigen. In 20 Jahren wurden 26 Patienten mit einem mittleren Alter von 12 Jahren behandelt. 16 hatten perforierende Verletzungen erlitten, 8 davon waren iatrogen entstanden und 10 infolge stumpfer Gewalteinwirkung, 7 davon im Rahmen von Frakturen. Die Thrombektomie mit direkter Naht sowie Veneninterponate waren die häufigsten Rekonstruktionsverfahren (je n=11), gefolgt von der Venenpatchplastik (n=3). Die Arterie wurde nur in einem Fall eines Aneurysma spurium der A. carotis externa aufgegeben. Zwei Patienten verstarben, eine Extremität musste amputiert werden. Im Langzeitverlauf zeigen sich nicht behandlungsbedürftige Dilatationen der Veneninterponate bei guter Durchgängigkeit und bisher keine signifikanten Wachstumsveränderungen der betroffenen Extremitäten.

Abstract

Vascular trauma in childhood and adolescence is a rare occurrence and remains a challenge for the vascular surgeon. Special technical skills are required. During the last 20 years, 26 patients with an average age of 12 years were treated: 16 had sustained perforating injury and 10 blunt trauma, in 7 cases accompanied by bone fractures. Surgical procedures performed were thrombectomy and direct suture as well as vein graft interposition (n=11 each). Only one vessel (branch of the external carotid artery) was ligated. Two patients died, and one limb loss occurred. Vascular reconstructions are patent with no significant dilatation of vein grafts or growth impairment of extremities.

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Authors and Affiliations

  1. Klinik für Gefäßchirurgie und Nierentransplantation, Heinrich-Heine-Universität Düsseldorf

    R. Huber, B. T. Müller & W. Sandmann

  2. Institut für Diagnostische Radiologie, Heinrich-Heine-Universität Düsseldorf

    S. Ernst

  3. Klinik für Gefäßchirurgie und Nierentransplantation, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf

    R. Huber

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  1. R. Huber
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  2. B. T. Müller
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Correspondence to R. Huber.

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Huber, R., Müller, B.T., Ernst, S. et al. Besonderheiten von Gefäßverletzungen im Kindesalter. Gefässchirurgie 9, 117–121 (2004). https://doi.org/10.1007/s00772-004-0336-5

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  • DOI: https://doi.org/10.1007/s00772-004-0336-5

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