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Abdominal imaging in child abuse

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Abstract

Introduction

Abdominal injuries in abused children are less common than musculoskeletal and craniocerebral injuries; however they carry high mortality and morbidity rates. In every case of trauma, regardless of aetiology, radiologists are responsible for the documentation and evaluation of injuries.

Injuries

Any abdominal injury pattern maybe observed following physical abuse and none is specific for abuse. However, a high index of suspicion should be maintained for every case of pancreatic, hollow viscous and other solid organ injuries, especially when there is delay in seeking help, a history of trauma to the child or siblings, young age, undernourishment, ecchymosis in non-ambulatory children or a non-plausible explanation for the injuries based on the provided history and the psychomotor condition of the child.

Imaging modalities

CT with intravenous contrast material is the imaging modality of choice in every suspected inflicted abdominal injury. US could be the first imaging test for abused children with a low probability of abdominal injury and for follow-up. Upper gastrointestinal series could reveal acute or resolving mural haematomas in children with equivocal CT or US findings.

Conclusion

Child abuse should be considered in the differential diagnosis of acute abdominal symptoms in young children.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, University Hospital of Heraklion, University of Crete, Stavrakia, Voutes, P.O. Box 2208, 71003, Heraklion, Crete, Greece

    Maria Raissaki

  2. Service de Radiologie Pédiatrique, Hôpital Arnaud de Villeneuve, Montpellier, France

    Corinne Veyrac

  3. Service de Radiologie Pédiatrique, Hôpital d’Enfants Armand-Trousseau, Paris, France

    Eleonore Blondiaux

  4. Department of Imaging, Children’s Hospital “Aghia Sophia”, Athens, Greece

    Christiana Hadjigeorgi

Authors
  1. Maria Raissaki
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  2. Corinne Veyrac
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  3. Eleonore Blondiaux
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  4. Christiana Hadjigeorgi
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Correspondence to Maria Raissaki.

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Raissaki, M., Veyrac, C., Blondiaux, E. et al. Abdominal imaging in child abuse. Pediatr Radiol 41, 4–16 (2011). https://doi.org/10.1007/s00247-010-1882-5

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  • DOI: https://doi.org/10.1007/s00247-010-1882-5

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