[Severe child abuse admitted to paediatric ICU]

Area of Science:

• Pediatric critical care medicine
• Child abuse and neglect research
• Forensic pediatrics

Context:

• Severe physical child abuse cases admitted to the Pediatric Intensive Care Unit (PICU) present diagnostic challenges.
• Distinguishing inflicted injuries from accidental trauma is critical for patient outcomes.

Purpose:

• To describe the clinical characteristics and outcomes of infants and young children admitted to the PICU with severe physical child abuse.
• To highlight the common injuries and diagnostic findings associated with severe child abuse.

Summary:

• This retrospective study analyzed 8 patients (3 male, 5 female) under 7 months old admitted to the PICU for physical child abuse.
• Neurological symptoms, including seizures and subdural hematomas, were most frequent. Fractures and retinal hemorrhages were also observed.
• Subdural hematomas requiring surgical drainage were common; one patient died, and three experienced severe neurological sequelae.

Impact:

• Accurate diagnosis of child abuse is essential to prevent further harm and recurrent injuries.
• Subdural hematomas are a frequent indicator of severe child abuse, often misdiagnosed as non-accidental neurological conditions.
• Findings underscore the importance of a high index of suspicion for child abuse in pediatric critical care settings.