Abstract Ref Number = APCP1258
THE DEATH OF A CHILD DUE TO PHYSICAL ASSAULT FROM HIS AUNT
Nicholas Adrian,Rodman Tarigan
Child Health Departement Padjadjaran University Hasan Sadikin General Hospital Bandung
Background : Injuries are relatively common in childhood. However, one should be suspicious for any unusual injury. Child abuse is considered a major public health issue. In the United States, approximately 650,000 child abuse cases are reported annually, in which 1,500 deaths are attributable to child abuse. Among those deaths, 80% of cases occur in children younger than 4 years old. A recent study reported that around two-thirds of all child abuse cases are physical assault in which the annual incidence reaches up to 295 assault cases in a region in Indonesia.
Case Presentation Summary : A two-years old alert male child was admitted to Dr. Hasan Sadikin General Hospital Emergency Room (ER) on January 12th 2018 by police officers due to suspicious and unusual wounds all over his body. Physical finding revealed newly-occuring wounds: open wound on the chin, bruises on the forehead, both ears, abdomen, back, and lower extremities; excoriated wound on the left cheek, nose tip, and chin. Older scars were also found on patient’s forehead, right chest, lower extremities and also bruises on healing process were found on the back. Head computed tomography (CT) scan revealed intracerebral, epidural and subdural hemorrhage, while abdominal and pelvic CT scan showed injury of the pancreas, peritonitis, and suspected bleeding of the lower thorax cavity. These findings resulted from blunt trauma conducted by his aunt. After receiving four-hours-long care in the ER, decrease of consciousness, seizure and respiratory arrest were observed and resuscitation was performed, the patient was then transferred to PICU. During observation in the PICU, further decrease of consciousness and blood pressure were observed thus another resuscitation was performed but failed. The patient died on January 13th 2018.
Learning Points/Discussion : The complexity of a child abuse cases may vary, ranging from only involving minor injuries to major life-threatening ones.
Keywords: child abuse physical assault unusual injury