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児童虐待による腹部損傷
Peter M Barnes1, Catherine M Norton, Frank D Dunstan
1Department of Child Health, Cardiff University, Academic Centre, Llandough Hospital, Penarth CF64 2XX, UK.
Lancet (London, England)
|July 19, 2005
まとめ
内腹部損傷による児童虐待の診断は困難です. 小腸の損傷は,虐待を受けた子供ではかなり多く見られ,特に軽度の転倒の後,慎重に検討する必要があります.
科学分野:
- 小児外科手術について
- 児童虐待 法医学 児童虐待 法医学
- トラウマ研究 トラウマ・リサーチ
背景:
- 虐待による子供の内腹部損傷の診断は,研究が限られているため,困難です.
- 子供の腹部損傷は,虐待や事故によって生じることがあるため,正確に区別することが必要です.
研究 の 目的:
- 0歳から14歳までの児童の虐待による腹部損傷の発生率を決定する.
- 虐待された子供の腹部損傷の特徴と原因を,事故で負傷した子供と比較する.
主な方法:
- 虐待の症例については,英国の小児科監視ユニット (British Paediatric Surveillance Unit) のデータ,事故による傷害については,トラウマ監査研究ネットワーク (Trauma Audit and Research Network) のデータを活用した.
- 怪我の種類,患者の人口統計,0歳から14歳までの子供のアウトカムを分析した.
主要な成果:
- 虐待による腹部損傷を受けた20人の子どもと,事故による負傷 (道路交通事故や転倒) を受けた164人の子どもを特定した.
- 虐待に関連した腹部損傷の発生率は,5歳未満の子どもでは年間100万人に2.33であった.
- 小腸の損傷は,転倒で負傷した子供 (5例) と比較して,虐待された子供 (11例) で有意に多く発生しました.
結論:
- 小腸の損傷は事故によって発生しますが,児童虐待のケースでは著しく一般的です.
- 小児における腹部,特に小腸の怪我は,軽度の落下によるものであれば,特に注意が必要です.
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