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Battered children with duodenal avulsion and transection
T Tracy1, T P O'Connor, T R Weber
1Department of Surgery, Cardinal Glennon Children's Hospital, St. Louis, MO 63104.
Insights
Severe duodenal injuries from child abuse can be treated successfully with surgical reconstruction. Early recognition of abuse-associated trauma is crucial for timely diagnosis and improved outcomes in pediatric patients.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Child Abuse Forensics
Background:
- Child abuse can lead to severe intra-abdominal injuries, including duodenal trauma.
- Retroperitoneal duodenal injuries in children are rare but life-threatening.
- Prompt diagnosis and surgical intervention are critical for patient survival.
Observation:
- Presents two cases of severe duodenal injury in 2-year-old children due to child abuse.
- One case involved an avulsion injury necessitating pyloric exclusion.
- Both children survived without anastomotic complications following surgical management.
Findings:
- Successful duodenal reconstruction relies on employing multiple surgical techniques.
- Recognition of abuse-associated malnutrition is important for managing these patients.
- A high index of suspicion for child abuse is vital in blunt abdominal trauma cases.
Implications:
- Effective surgical strategies can lead to favorable outcomes in pediatric duodenal trauma from abuse.
- Preventing diagnostic delays through heightened suspicion can improve survival rates.
- This highlights the importance of multidisciplinary approaches in managing child abuse victims with severe injuries.
Abstract:
Two cases of severe duodenal injury following child abuse are presented. One avulsion injury required pyloric exclusion. Both 2-year-old children survived without anastomotic complications. Survival after these injuries rests on the ability to apply multiple techniques for duodenal reconstruction, as well as the recognition of individual cases of abuse-associated malnutrition. A high index of suspicion following abuse-associated blunt abdominal trauma will prevent diagnostic delay in children with retroperitoneal duodenal injuries.