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Visceral Injuries

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

Review last updated in May 2014

This review includes visceral injuries not encompassed within the other reviews, apart from ear nose and throat injuries, which are the subject of an ongoing review. Whilst almost every organ of the body has been reported as having been injured, the literature predominantly addresses abdominal injuries. Abdominal injuries are a significant cause of morbidity and mortality amongst abused children 1,2. The challenge for clinicians is to recognise when such injuries have occurred, as many symptoms are non-specific and occur predominantly in pre-schoool children 3.

 

There is a disappointing lack of new literature in this area, but further details of intra-thoracic injuries and the potential role of liver enzymes to identify occult abdominal injury continue to be explored.

 

 

 The review seeks to answer the following review questions:

 

  1. What are the features of visceral injuries occurring as a consequence of physical abuse?

  2. What is the value of non-radiological investigations in detecting abusive abdominal injury?

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References

  1. Ledbetter DJ, Hatch Jr EI, Feldman KW, Fligner CL, Tapper D. Diagnostic and surgical implications of child abuse. Archives of Surgery. 1988;123(9):1101-1105 [Pubmed]
  2. Sidebotham P, Bailey S, Belderson P, Brandon M. Fatal child maltreatment in England, 2005- 2009 Child Abuse & Neglect. 2011;35(4):299-306. [Pubmed]

  3. Gaines BA, Shultz BS, Morrison K, Ford HR. Duodenal injuries in children: Beware of child abuse. Journal of Pediatric Surgery. 2004;39(4):600-602 [Pubmed]

 

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