Abstract
Background
Although the abdominopelvic CT findings of abdominal trauma in children have been described, little has been written about the subset of children who are victims of abuse.
Objective
Our purpose is to describe abdominopelvic injuries in abused pre-school-age children as identified on CT.
Materials and methods
An IRB-approved retrospective review of our institutional child abuse registry was performed. Searching a 14-year period, we identified 84 children ≤ 5 years of age with medically diagnosed abuse who underwent CT. We reviewed imaging studies, operative reports, autopsy findings and patient outcomes. Consensus review of the CT examinations was performed by CAQ–certified pediatric radiologists, and findings were categorized as normal or by injury types (solid organ versus bowel). The injuries were analyzed in light of existing literature on pediatric accidental and non-accidental injuries.
Results
Of the 84 children, 35 (41.7%) had abdominal injuries. Abdominal injuries included liver (15), bowel (13), mesentery (4), spleen (6), kidneys (7), pancreas (4) and adrenal glands (3). Of these children, 26% (9/35) required surgical intervention for bowel, mesenteric and pancreatic injuries. Another 9/35 children died, not as a result of abdominal injuries but as a direct result of inflicted intracranial injuries.
Conclusion
Our data indicate that abdominal injuries in abused children present in a pattern similar to that of children with accidental abdominal trauma, underscoring the need for vigilance and correlative historical and clinical data to identify victims of abuse. Mortality in abused children with intra-abdominal injury was frequently related to concomitant head injury.
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Acknowledgements
This work was presented at the 2008 Society for Pediatric Radiology meeting in Scottsdale, AZ.
Statistics support was provided by Vanderbilt CTSA grant 1 UL1 RR024975 from the National Center for Research Resources, National Institutes of Health.
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Hilmes, M.A., Hernanz-Schulman, M., Greeley, C.S. et al. CT identification of abdominal injuries in abused pre-school-age children. Pediatr Radiol 41, 643–651 (2011). https://doi.org/10.1007/s00247-010-1899-9
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DOI: https://doi.org/10.1007/s00247-010-1899-9