Document Type : Case Report
1 Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
2 Department of Emergency Medicine, Faculty of Medicine, Jahrom University of Medical sciences, Jahrom, Iran
Introduction: Child abuse has been defined as allowing others to cause physical, emotional, and sexual harm, and also physical and emotional pain to a child. The present study was a report on a case of physical and sexual child abuse accompanied by traumatic brain injury (TBI) referred to an emergency department.
Case Presentation: A 4-year-old child was rushed into an emergency department by her mother. At the time of hospital admission, the child was feeling confused and drowsy and had symptoms of hemorrhage in the right preperitoneal space as well as bleeding from the mouth. According to the pattern of the child’s admission to the emergency department, contradictory descriptions by parents, clinical examinations, and TBI pattern; the probability of a case of child abuse was raised. Thus; neurosurgery, legal medicine, gynecology, and surgery consultations were requested. With regard to the brain injury and epidural hematoma, immediate measures (i.e. head lifting, taking Dilantin, blood glucose control, blood pressure control, and maintaining adequate oxygen saturation in the arterial blood) were taken to put a stop to secondary brain injury, and the patient was then transferred to the intensive care unit (ICU) for further treatments.
Conclusion: In the present case study, the child was seriously examined and followed up. In conclusion; 20 days later, the case was discharged from the pediatric ward with good medical conditions, and received counseling and psychiatric services for one year.
Training, practice, and policy issues. Child Youth Serv Rev 2000; 22(5): 315-32. doi: 10.1016/S0190-7409(00)00083-9.
2. Sadock BJ, Sadock VA. Kaplan & Sadock’s Comprehensive text book of psychiatry. 7th ed. Philadelphia: Lippincott
Williams & Wilkins; 2000.
3. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. 2010. Child Maltreatment 2009. Available from: http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#can.Accessed May 1, 2011.
4. Christian CW, Schwarz DF. Child maltreatment and the transition to adult-based medical and mental health care. Pediatrics 2011; 127(1): 139-45. doi: 10.1542/peds.2010-2297.
5. Christopher J, Helga GI, Jane M. Child Abuse and Neglect. 2nd ed. London: Churchill Livingstone; 1999.
6. Trokel M, Discala C, Terrin NC, Sege RD. Patient and injury characteristics in abusive abdominal injuries. Pediatr Emerg Care 2006; 22(10): 700-4. doi: 10.1097/01.pec.0000238734.76413.d0.
7. Ross CA, Keyes BB, Xiao Z, Yan H, Wang Z, Zou Z, et al. Childhood physical and sexual abuse in China. J Child Sex Abus 2005; 14(4): 115-26. doi: 10.1300/J070v14n04_06.
8. Shojaeizadeh D. Child abuse in the family: An analytical study. Iran J Public Health 2001; 30(1-2): 45-8.
9. Cairns AM, Mok JY, Welbury RR. The dental practitioner and child protection in Scotland. Br Dent J 2005; 199(8):
517-20. doi: 10.1038/sj.bdj.4812809.
an adult community sample. Child Abuse Negl 2004; 28(2):167-80. doi: 10.1016/j.chiabu.2003.09.012.