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Recognition and Management of Nonaccidental Esophageal Perforation

Ryan Bishop1, Rishabh Sethia2, Charles Elmaraghy2,3

  • 1College of Medicine.

Pediatrics
|December 3, 2021
PubMed

Insights

Nonaccidental trauma, often missed, can cause severe pediatric injuries. This case highlights diagnosing inflicted esophageal perforation, a rare but critical presentation in infants.

Area of Science:

  • Pediatric Traumatology
  • Gastrointestinal Surgery
  • Child Abuse Recognition

Background:

  • Nonaccidental trauma is a frequent pediatric issue, frequently overlooked by medical professionals.
  • Common signs include bruising, burns, fractures, and head injuries.
  • Atypical presentations, such as pharyngeal and esophageal trauma, require heightened clinical suspicion.

Observation:

  • A 5-week-old infant presented with symptoms suggestive of trauma.
  • The infant was diagnosed with an esophageal perforation.
  • The perforation was determined to be inflicted in origin.

Findings:

  • Esophageal perforation is a rare but severe consequence of nonaccidental trauma in infants.
  • Prompt diagnosis and management are crucial for patient survival and recovery.
  • This case underscores the importance of considering inflicted esophageal injury in the differential diagnosis of infant trauma.

Implications:

  • Physicians must be vigilant in recognizing subtle signs of nonaccidental trauma.
  • Expanding diagnostic criteria to include esophageal trauma can improve early detection.
  • Timely intervention in cases of inflicted esophageal perforation can prevent fatal outcomes.

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