Can falls on stairs result in small intestine perforations?
OBJECTIVE
Abusive parents often report that a fall on stairs resulted in their children's injuries. This review explores whether there is any evidence in the medical literature that a fall on stairs could be a plausible explanation for a small intestine perforation.


METHODS
The English-language medical literature was searched by Medline, for a 29-year period (1970-1998), for reports of the types of injuries sustained in falls on stairs and for reports of the types of blunt abdominal trauma that result in small intestine perforations. Articles that exclusively focused on infant walker injuries or the elderly were excluded. Duodenal, jejunal, and ileal perforations were included, whereas intestinal hematomas and undescribed intestinal injuries were excluded. All types of injuries to the stomach, colon, and rectum were excluded.


RESULTS
Falls on stairs were not reported to be a cause for any of the 312 cases of small intestine perforations reviewed. There were no reports of any intraabdominal injuries, including small intestine perforations, in any of the 677 cases of falls on stairs reviewed. Falls on stairs rarely resulted in any type of truncal injury.


CONCLUSIONS
Although falls on stairs have been reported to be the most common cause of injury in childhood, no evidence was found to support the contention that an unobstructed fall on stairs could be consistent with perforation of the small intestine.
Child and Adolescent Psychiatry Fellowship Program, University of South Dakota, Sioux Falls, South Dakota, USA. chuntimer@aol.com
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Huntimer
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Muret-Wagstaff
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Leland
D000007:Abdominal Injuries / Q000453:epidemiology / Q000209:etiology*; D000058:Accidental Falls / Q000706:statistics & numerical data; D015984:Causality; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000706:statistics & numerical data; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D007416:Intestinal Perforation / Q000453:epidemiology / Q000209:etiology*; D007421:Intestine, Small / Q000293:injuries*; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000209:etiology*