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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
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[Bruises in infants should always be accounted for]

Dorien M Broekhuijsen-van Henten1, Ad N Bosschaart, Huub G T Nijs

  • 1Universitair Medisch Centrum Utrecht, locatie Wilhelmina Kinderziekenhuis, afd. Algemene Pediatrie, Utrecht, The Netherlands. d.m.broekhuijsen-vanhenten@umcutrecht.nl

Nederlands Tijdschrift Voor Geneeskunde
|September 30, 2009
PubMed

Insights

Bruising (hematomas) in infants can indicate child abuse. Physicians must carefully evaluate infant hematomas, considering both bleeding disorders and potential maltreatment for child safety.

Area of Science:

  • Pediatrics
  • Forensic Medicine
  • Child Health

Background:

  • Child abuse is a significant public health issue often underdiagnosed by medical professionals.
  • Infants present unique challenges in diagnosing the cause of injuries.

Observation:

  • Three male infants under one year of age presented with hematomas.
  • One case involved a temporal association with a childminder, though causality was unclear due to a concurrent illness.
  • Two cases were diagnosed with inflicted traumatic brain injury, one with an additional tibial fracture, following suspicion of maltreatment.

Findings:

  • Hematomas in non-ambulatory infants warrant careful evaluation for potential child abuse.
  • Thorough investigation should include assessment for bleeding disorders and a detailed history of injury circumstances.
  • Pattern and location of hematomas are critical diagnostic clues.

Implications:

  • Early recognition and intervention are crucial in suspected child abuse cases.
  • Physicians must maintain a high index of suspicion for non-accidental trauma in infants presenting with unexplained injuries.
  • Ensuring child safety requires prompt action when abuse is identified.

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