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.
Visceral consequences of injury
- Rhabdomyolysis has been described as a consequence of severe physical abuse with multiple extensive bruises, and has resulted in renal failure 1
- Commotio cordis has been described where the assault on the child involves a direct blow to the chest resulting in ventricular dysrhythmia and subsequent death. Significantly, no pathological abnormality was found in the heart on autopsy and in only one case were co-existent rib fractures present (in this child the perpetrator also admitted to severe squeezing of the chest) 2-4
Vulnerability of infants to abdominal injury
- Young children are suscebtible to injury due to a less muscular, thin abdominal wall, the diaphragm being more horizontal and the liver and spleen more anterior, thus less protected by ribs. As the ribs themselves are elastic and more compressible, direct trauma to the chest may crush solid organs below 5
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References
- Peebles J, Losek JD. Child physical abuse and rhabdomyolysis: Case report and literature review. Pediatric Emergency Care. 2007;23(7):474-477 [Pubmed]
- Baker AM, Craig BR, Lonergan GJ. Homicidal commotio cordis: the final blow in a battered infant. Child Abuse and Neglect. 2003;27(1):125-130 [Pubmed]
- Denton, JS, Kalelkar MB, Denton JS, Kalelkar MB. Homicidal commotio cordis in two children. Journal of Forensic Sciences. 2000;45(3):734-735 [Pubmed]
- Boglioli LR, Taff ML, Harleman G. Child homicide caused by commotio cordis. Pediatric Cardiology. 1998;19(5):436-438 [Pubmed]
- Gaines BA, Ford HR. Abdominal and pelvic trauma in children. Critical Care Medicine. 2002;30(11 Suppl):S416-23 [Pubmed]