Internal abdominal injury due to child abuse
This two-year study of internal abdominal injury due to child abuse was undertaken from March 2001 to March 2003. There were several important questions it considered: how common is this condition in the UK? How do children present, and what is their eventual clinical outcome? What associated signs or injuries should be looked for in addition? Is there a pattern of injury that is more likely to indicate a non-accidental rather than an accidental cause? Are there any pointers to prevention?
Lead investigator
Professor J Sibert
About the study
At the time of surveillance, in the UK, according to an NSPCC survey, 7% of young adults have experienced serious physical injury at the hands of their carers during their childhood.
The skeletal and intracranial manifestations of physical child abuse were well described in the medical literature, with head injuries being the leading cause of death in children injured non-accidentally.
Internal abdominal injuries due to child abuse were described, but accounted for less than 2% of all non-accidental injuries. However, this type of injury was the second most common cause of death following child abuse, with mortality rates as high as 40-50% reported in the USA. Child abuse had been identified along with motor vehicle trauma as the major aetiological factors in childhood internal abdominal injury.
There was only a small body of UK literature available on the subject of internal abdominal injury due to child abuse. Any person involved in analysing a suspected case as part of a child protection investigation may have faced real difficulties in looking for information.
In the USA, there were suggestions that hollow viscous injury was the most commonly identified internal abdominal injury seen as a result of abuse. Whereas accidental injury was more likely to be associated with injury to solid organs within the abdomen, for example, the spleen or kidney. However, it was clear from available case reports that any internal abdominal organ could be injured following abuse.
There were a number of important questions to consider: how common is this condition in the UK? How do children present, and what is their eventual clinical outcome? What associated signs or injuries should be looked for in addition? Is there a pattern of injury that is more likely to indicate a non-accidental rather than an accidental cause? Are there any pointers to prevention?
This background prompted the research team to undertake a two-year study of internal abdominal injury due to child abuse.
Duration
March 2001 – March 2003
Published papers
BPSU 17th Annual report 2002 – 2003
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