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Evaluation of the abdomen in the setting of suspected child abuse

  • Child abuse imaging
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Abusive intra-abdominal injuries are less common than other types of injuries, such as fractures and bruises, identified in victims of child physical abuse, but they can be deadly. No single abdominal injury is pathognomonic for abuse, but some types and constellations of intra-abdominal injuries are seen more frequently in abused children. Identification of intra-abdominal injuries can be important clinically or forensically. Injuries that do not significantly change clinical management can still elevate a clinician’s level of concern for abuse and thereby influence subsequent decisions affecting child protection efforts. Abusive intra-abdominal injuries can be clinically occult, necessitating screening laboratory evaluations to inform decisions regarding imaging. Once detected, consideration of developmental abilities of the child, type and constellation of injuries, and the forces involved in any provided mechanism of trauma are necessary to inform assessments of plausibility of injury mechanisms and level of concern for abuse. Here we describe the clinical, laboratory and imaging evaluation of the abdomen in the setting of suspected child abuse.

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Authors and Affiliations

  1. Safe Place: The Center for Child Protection and Health, Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    M. Katherine Henry, Colleen E. Bennett & Joanne N. Wood

  2. Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, 2716 South St., Philadelphia, PA, 19146, USA

    M. Katherine Henry & Joanne N. Wood

  3. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    M. Katherine Henry & Joanne N. Wood

  4. Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    M. Katherine Henry & Sabah Servaes

  5. National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA, USA

    Colleen E. Bennett

  6. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA

    Colleen E. Bennett & Joanne N. Wood

  7. PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Joanne N. Wood

  8. Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Sabah Servaes

Authors
  1. M. Katherine Henry
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  2. Colleen E. Bennett
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  3. Joanne N. Wood
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  4. Sabah Servaes
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Corresponding author

Correspondence to M. Katherine Henry.

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Conflicts of interest

The Children’s Hospital of Philadelphia has received payment for Dr. Henry’s, Dr. Bennett’s and Dr. Wood’s expert testimonies following subpoenas in cases of suspected child abuse.

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Henry, M.K., Bennett, C.E., Wood, J.N. et al. Evaluation of the abdomen in the setting of suspected child abuse. Pediatr Radiol 51, 1044–1050 (2021). https://doi.org/10.1007/s00247-020-04944-2

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  • DOI: https://doi.org/10.1007/s00247-020-04944-2

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