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Abdominal and Thoracic Trauma

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A Practical Guide to the Evaluation of Child Physical Abuse and Neglect

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Abstract

Abdominal and thoracic injuries are some of the most dangerous types of injuries resulting from child abuse. Abusive abdominal trauma ranks as the second most lethal type of inflicted injuries in children after head injuries. Victims of child abuse with significant abdominal and thoracic injuries often succumb to their injuries before diagnosis and treatment. They are young and defenseless and unable to brace themselves against the violent forces that cause these types of injuries. Blunt force caused by kicking or punching is a common mechanism. Several factors such as inaccurate and incomplete history offered by the accompanying adult, the lack of external markers, and the lack of immediately evident specific signs and symptoms often lead to a delayed presentation and diagnosis. Victims presenting late with cardiovascular instability may be assumed to have a medical cause and receive standard cardiopulmonary resuscitation instead of management based on trauma protocols. This explains the high fatality rates associated with these injuries.

This chapter describes the prevalence, nature, and extent of inflicted abdominal and thoracic injuries in children. It will guide the reader in making an early diagnosis by maintaining a high index of suspicion, in the appropriate use of diagnostic tests, and in conducting a comprehensive evaluation of injuries in childhood victims of inflicted visceral trauma.

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Authors and Affiliations

  1. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    Rohit Shenoi

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  1. Rohit Shenoi
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Correspondence to Rohit Shenoi .

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Editors and Affiliations

  1. Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, UT, USA

    Angelo P. Giardino

  2. Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA

    Michelle A. Lyn

  3. Department of Integrative Care, School of Nursing at Houston, University of Texas, Houston, TX, USA

    Eileen R. Giardino

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Shenoi, R. (2019). Abdominal and Thoracic Trauma. In: Giardino, A., Lyn, M., Giardino, E. (eds) A Practical Guide to the Evaluation of Child Physical Abuse and Neglect. Springer, Cham. https://doi.org/10.1007/978-3-030-00635-8_5

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  • DOI: https://doi.org/10.1007/978-3-030-00635-8_5

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