title: Child maltreatment and neglect, or poverty and ignorance: An old case from the museum.
abstract: We present an old case, from the year 1928, of a girl who, as an 18-month-old, had ingested a small amount of lye, and over time oesophageal stenosis had developed. However, her parents had not taken her to hospital until 4 months after the event, after an episode of bloody vomiting. She spent the remaining time of her life in the hospital, where she died as a 3-year-old. Her parents did not visit once during that time. After the autopsy, the opinion about the cause and mechanism of death had five steps: the immediate cause of death was purulent pneumonia, which was a complication of small pox and severe undernourishment; the severe undernourishment was the consequence of a narrowed part of the oesophagus; this developed due to the ingestion of the corrosive agent; and it remained uncertain whether the ingestion of the corrosive agent was accidental or homicidal in manner. The presented case could be an example of possible child maltreatment and neglect in rural parts of society, from almost 90 year ago; at the time these cases were not recognized and treated as they would be today. This is also an example of how the forensic pathologist, via the conclusion about the cause of death, highlighted the parents' carelessness and neglect of the child.
authors.affiliation: Institute of Forensic Medicine, University of Belgrade, School of Medicine, Serbia.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Nikolić
authors.affiliation: Institute of Forensic Medicine, University of Belgrade, School of Medicine, Serbia vladinmejl@yahoo.com vladimir.zivkovic@mfub.bg.ac.rs.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Živković
mesh_terms: D001344:Autopsy; D002649:Child Abuse / Q000266:history*; D005260:Female; D049673:History, 20th Century; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders; D011014:Pneumonia / Q000503:physiopathology; D011041:Poisoning / Q000150:complications*; D011203:Poverty; D012424:Rural Population
keywords: Forensic pathology; child abuse and neglect; forensic medicine; ingestion of alkali; ingestion of lye; oesophageal stenosis