Child Abuse and Neglect: A Diagnostic Guide for Physicians, by Vincent J. Palusci, Howard Fischer

By Vincent J. Palusci, Howard Fischer

Bruises -- Abusive burns -- Cutaneous stipulations mimicking baby abuse -- Imaging baby abuse -- Ocular trauma -- Otolaryngologic manifestations of abuse and overlook -- popularity of kid abuse through dentists, health and wellbeing care pros, and legislation enforcement -- Abusive belly trauma -- Anogenital findings and baby sexual abuse -- baby maltreatment fatalities -- Failure to thrive -- Munchausen syndrome via proxy

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Extra info for Child Abuse and Neglect: A Diagnostic Guide for Physicians, Surgeons, Pathologists, Dentists, Nurses and Social Workers

Example text

Toddlers are frequently the victims of abuse because this is a difficult developmental stage, which includes a desire for independence, but a continued dependence on the caregiver. The family make-up of these children often reveals there are several children in the home, with the victim being the youngest3. Previous protective service involvement was found in 46–53% of children with intentional burns versus 4–11% of accidental burns9,13. 3 found a history of nonaccidental trauma in a sibling in 20–23% of children with nonaccidental burns (Table 6).

His mother indicated to the anonymous call was made to the child protective doctor that the patient’s 7-year-old sister pulled on services regarding his bruises. Examination shows the penis the day before. Reportedly, the child was in foreskin edema and swelling with possible ecchymosis the process of toilet training and the mother stated of the glans penis, bruises noted on the forehead and that the child walks around frequently without a scalp, as well as left posterior shoulder, left hip, left diaper/nappy.

31 32 Chapter 2 Although it may be very time consuming, an important consideration in the detection of abusive bruising is to be thorough in your physical examination. Clearly, subtle findings such as bruises to the back, digits, genitals, buttocks, or even the back of the ears cannot be seen unless the child is fully undressed and a thorough head to toe examination is performed. Such an examination is essential in all patients whose presentation may be associated with abuse (74, 75). This would include patients with sudden infant death syndrome, apparent life threatening events, failure to thrive, new onset seizures, and all patients presenting with trauma (fractures, burns, bruises, and lacerations).

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