[Bruises in infants should always be accounted for].
Haematomas were observed in three male infants under 1 year of age. In the first case, no suspicion regarding child abuse was raised, but, in retrospect, the appearance of haematomas coincided with the times he had been with a childminder. When he was admitted to hospital for a different reason, namely a serious airway infection, the causal relationship could no longer be established. In the second case, the grandparents told the general practitioner about their suspicion of maltreatment. CT revealed inflicted traumatic brain injury. In the third case, inflicted traumatic brain injury was also observed, in addition to a corner fracture of the tibia. Child abuse is a widespread problem that is not always recognized by physicians. Haematomas in infants should be evaluated carefully with thorough investigations for bleeding disorders on one hand and the possibility of child abuse on the other. A careful history concerning the circumstances of injury is essential, keeping in mind the age and development of the child. Localization and patterns of haematomas should also be evaluated. Haematomas in children who do not crawl or walk should lead to suspicion of child abuse. In the case of child abuse, direct action should be taken to ensure the safety of the child.
Broekhuijsen-van Henten
Dorien M
DM
Universitair Medisch Centrum Utrecht, locatie Wilhelmina Kinderziekenhuis, afd. Algemene Pediatrie, Utrecht, The Netherlands. d.m.broekhuijsen-vanhenten@umcutrecht.nl
Bosschaart
Ad N
AN
Nijs
Huub G T
HG
D001930:Brain Injuries / Q000175:diagnosis* / Q000209:etiology; D002649:Child Abuse / Q000175:diagnosis* / Q000706:statistics & numerical data; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D012307:Risk Factors