title: [Total duodenal section. A reliable indicator of severe physical abuse].
abstract: BACKGROUND
  Rupture of the hollow viscera due to battered child syndrome is an unusual clinical finding and it is even less likely when we encounter total duodenum section. The literature on child abuse does not include visceral lesions as part of the spectrum. The aim of this study was to analize if complete duodenal section is a reliable indicator of severe physical abuse. Data were statistically analyzed using chi-square tests, likelihood ratios and the Cochran-Mantel-Haentzel test.
  
  
  METHODS
  Four children were admitted with a battered child syndrome diagnosis.
  
  
  RESULTS
  All participants were surgically treated and the finding was total section of the duodenum. The postoperative course was normal. Statistical tests were p<0.0001 and the likelihood ratio 18.7
  
  
  CONCLUSIONS
  Duodenal rupture is a statistically reliable indicator of a severe form of physical abuse in children.
authors.affiliation: Departamento de Cirugía, Hospital Pediátrico Moctezuma, México DF, México. hpmoctezuma@yahoo.com
authors.forename: Carlos
authors.initials: C
authors.lastname: Baeza-Herrera
authors.forename: Arturo
authors.initials: A
authors.lastname: Arcos-Aponte
authors.forename: Alín
authors.initials: A
authors.lastname: Villalobos-Castillejos
authors.forename: Javier
authors.initials: J
authors.lastname: López-Castellanos
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cortés-García
mesh_terms: D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D004386:Duodenum / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index