بسم الله الرحمن الرحيم

CHILD ABUSE By Prof. Dr. Hana’a M. Abdel Rahman

Definition Repeated, non accidental injuries, sometimes fatal, caused through episodes of violence to children, by either parents or guardians.

Characters of the family 1. Low educational level 2. Low economic life 3. Big family number 4. Family with stressful life events

Characters of the parents 1. Young age 2. Emotionally immature and aggressive 3. Divorce 4. They are themselves battered children

Characters of the Child 1. An annoying child 2. Hyperactive, 3. Persistently soiling himself 4. Unwanted child

Nature of Injuries

Soft tissue injuries · * Face, neck & head especially ears and checks due to slapping · * Sides of the chest due to gripping of the victim while forcibly shaking · * Limbs & abdomen * Bites are very common

Soft tissue injuries Face, neck & head especially ears and checks due to slapping Sides of the chest due to gripping of the victim while forcibly shaking Limbs & abdomen Bites are very common

Eye injuries subconjunctival hemorrhage retinal detachment

Head injuries very common and they are usually the cause of death. They are due to impact of the head against a solid object e.g., the earth. They are in the form of fissure fractures, subdural hemorrhage and brain damage.

Visceral injuries e.g., rupture liver, intestine caused by direct blows on the abdomen

Skeletal injuries X-ray may show rib or clavicle fractures, separation of epiphysis, elevated periosteum, subperiosteal hemorrhage and calcification. The Figure: Frontal radiograph of the chest demonstrates multiple rib fractures with callous formation, including a fracture of the left 2nd and 6th ribs posteriorly. Posterior rib fractures are highly suggestive of child abuse (from forceful squeezing )

Burns Very common due to:  Stubbing by cigarette ends upon the skin  Placing the child on a hot stove * Dipping the victim in hot fluid

Diagnosis of battered child 1. Different types of injuries at the same time 2. The injuries are usually of different ages 3. Delay in seeking medical advice 4. Discrepancy between the history given by the parents and the physical findings on examination 5. Variability in parental explanation of these injuries

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