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Inclusion criteria

We included high quality case series / studies, where abuse had been confirmed. To minimise circularity in relation to confirmation of abuse, we included only those studies where the rank of abuse was 1 or 2. In order to address the role of non-radiological investigations in detecting abusive abdominal injury, we accepted studies with a lower rank of abuse (4-5) for this question, in order to determine if occult injuries were present.

 

See evidence sheets and critical appraisal forms for each year’s update

 

Inclusion

Exclusion

 

children aged 0 to < 18 years

 

studies with mixed child and adult subjects, where the children’s data could not be extracted

 

alive or deceased on presentation

 

inadequate clinical detail of included cases

 

injury confirmed by one or more of the following:

 

contrast studies

 

computed tomography (CT) scanning, with or without contrast

 

surgery

 

post mortem examination

 

studies including a mixture of abusive and accidental injuries, where the details of these two groups could not be extracted

 

 

studies exclusively addressing the outcome / management of visceral injuries

 

 

studies of sexual abuse, thus all ano-genital / rectal injuries

 

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