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A life-threatening presentation of child physical abuse: jejunal perforation

Meda Kondolot1, Fatih Yağmur, Ali Yıkılmaz

  • 1Unit of Social Pediatrics, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey. medakondolot@gmail.com

Pediatric Emergency Care
|November 10, 2011
PubMed

Insights

Diagnosing child abuse in children with intra-abdominal injuries can be challenging. This case highlights jejunal perforation and other injuries as indicators of abuse, necessitating prompt medical and protective interventions.

Area of Science:

  • Pediatrics
  • Child Abuse Forensics
  • Abdominal Trauma

Background:

  • Intra-abdominal injuries are a leading cause of death in abused children.
  • Distinguishing accidental from abusive abdominal trauma is clinically difficult, particularly without other signs.
  • Limited literature exists on diagnosing child abuse in pediatric intra-abdominal injury cases.

Observation:

  • A child presented with fever, cough, and vomiting, later found to have jejunal perforation.
  • The patient also exhibited multiple soft tissue injuries and an occipital fracture.
  • Surgical intervention included exploratory laparotomy and end-to-end jejunal anastomosis.

Findings:

  • The presented case demonstrates a link between severe intra-abdominal injury (jejunal perforation) and non-accidental trauma in a child.
  • Multiple injuries, including soft tissue damage and skull fractures, supported the diagnosis of child abuse.
  • The child protective team's involvement was crucial for diagnosis and intervention.

Implications:

  • This case underscores the importance of considering child abuse in pediatric patients with unexplained intra-abdominal injuries.
  • Early recognition and intervention by child protective services are vital for the safety and well-being of abused children.
  • Further research is needed to improve diagnostic criteria for non-accidental abdominal trauma in children.

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