Femoral artery and vein injuries in a child due to firecracker explosion: a case report.

Background: Traumatic vascular injuries in the pediatric patient population are uncommon, especially firecracker blast injuries. Extremities are more frequently affected. Vascular lesions in children have unique characteristics compared to adults, including small vessel diameters, continued growth and development, and susceptibility to vasospasm. There are no clear guidelines for vascular repair and postoperative drug therapy. This may present some challenges during treatment. The study's purpose is to retrospectively analyze a case of femoral artery and vein injuries in a child due to firecracker explosion, and to summarize the characteristics of femoral artery and vein rupture in children and the diagnostic and therapeutic experience.

Case description: We reported a 9-year-old boy with a firecracker injury to the perineum resulting in a left femoral artery and femoral vein rupture. In particular, the wound from firecracker explosion is located at the point of body projection of the spermatic cord, rather than the femoral artery and femoral vein. Emergency compression of the wound to stop bleeding provided an opportunity for subsequent surgical treatment. The intraoperative exploration revealed that the left femoral artery was mostly dissected along a 3-cm long section with a disfigured wall, and the left femoral vein was partially dissected with its anterior wall partially disrupted and missing. The child was subjected to left femoral artery autologous great saphenous vein interposition and left femoral vein repair with patch plasty. The patient had a successful surgery with good follow-up.

Conclusions: Pediatric femoral arteriovenous injury is a rare and complex condition, often associated with critical complications, challenging surgical interventions, and a high risk of mortality and disability. The location of body wounds may contribute to delayed diagnosis of the condition, emphasizing the importance of timely physical examination for early diagnosis. Timely and accurate vascular repair is paramount for saving lives and minimizing the risk of limb amputation. Long-term postoperative follow-up is necessary to monitor the patency of the repaired vessels and promptly detect any complications.