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Fri Nov 21 20:19:10 GMT 2008

Dell,

Have you checked with the pediatric radiologists at St. Joseph's Medical Center. Perhaps they know of something written in their literature from years past.

Dutch 

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-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of moore677 at aol.com
Sent: Friday, November 21, 2008 1:16 PM
To: trauma-list at trauma.org
Subject: Re: WIDE MEDIASTINUM IN CHILDREN

Thanks for replying, and you are right in that there is likely not a good answer.? I have not found anything in the literature on how to define a wide mediastinum in a child, and while very rare, the adult definition will not suffice for a 4 year old.? We have admitted two this past year, both under 10.? 

Anyone else like to comment?????

Dell................

-----Original Message-----
From: Bjorn, Pret <pbjorn at emh.org>
To: Trauma &amp; Critical Care mailing list <trauma-list at trauma.org>
Sent: Fri, 21 Nov 2008 1:08 pm
Subject: RE: WIDE MEDIASTINUM IN CHILDREN

I'm disappointed that your interesting question hasn't found a reply.
My long experience as a member and admirer of the Trauma List leaves me thinking that there simply isn't a good answer.  

That said, and assuming you're looking for an aortic injury, I think the incidence among pre-adolescents is almost exactly zero.  Isn't it?  So in practical terms you're talking about a small handful of teenagers, for whom the 8-cm rule (and a whole lot of clinical context) should suffice.  

Points for trying?

Pret Bjorn, RN
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of moore677 at aol.com
Sent: Wednesday, November 19, 2008 2:01 PM
To: trauma-list at trauma.org
Subject: WIDE MEDIASTINUM IN CHILDREN

We have defined a wide mediastinum in an adult trauma patient as >8cm.?
Can anyone tell me how we define a pediatric patient with a wide mediastinum?

Forrest "Dell" Moore, MD, FACS
Trauma Critical Care Surgery
St. Joseph's Hospital and Medical Center Phoenix, AZ
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WIDE MEDIASTINUM IN CHILDREN