Pancreatic injury: accidental or nonaccidental.
The diagnosis of abuse in a child with occult abdominal injuries is difficult. Not many patients with nonaccidental trauma present with a clear history of the injury. The absence of a reliable history in patients with nonaccidental trauma makes determination of an exact mechanism difficult. In most cases, patients present to the emergency department with inaccurate or misleading histories; some give no history of trauma, which may delay recognition of serious abdominal injuries. In addition, the child may have other injuries, such as neurologic or musculoskeletal, which divert attention from occult abdominal injuries. Pancreatic and duodenal injuries are considered specific for abuse. We report a child with pancreatic injury without an appropriate history of trauma, determined to be caused by nonaccidental trauma.
Waseem
Muhammad
M
Department of Emergency Medicine, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA. waseemm2001@hotmail.com
Perales
Orlando
O
D000007:Abdominal Injuries / Q000000981:diagnostic imaging / Q000209:etiology; D000059:Accidents; D000208:Acute Disease; D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D004386:Duodenum / Q000293:injuries; D004630:Emergencies; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000000981:diagnostic imaging / Q000209:etiology; D022125:Lacerations / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D008643:Mesentery / Q000098:blood supply / Q000293:injuries; D009780:Occult Blood; D010179:Pancreas / Q000293:injuries*; D010195:Pancreatitis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology*