- Internal organ injuries
are second only to head trauma as the most common causes of death in
- Nonaccidental internal injuries
usually involve structures below the diaphragm.
- Accidental abdominal injuries
usually involve a long fall to a flat surface, a motor vehicle accident
or, rarely, are the result of contact sports. Accidental abdominal injuries
usually involve older children who are brought to medical attention
immediately, whereas children with nonaccidental abdominal injuries
will be younger, and a delay in seeking medical attention is more common.
Nonaccidental abdominal injuries more commonly involve hollow organs
(e.g., the gut and stomach) than accidental injuries, but the liver,
spleen, and pancreas can all suffer nonaccidental injury. For some reason,
the kidneys are rarely injured.
- Although there are signs
and symptoms, in most cases of abdominal organ injury there are no external
signs of trauma. This is due to the pliability of the abdominal wall
and its ability to absorb trauma without showing bruises.
- Unusual clinical findings
may indicate abuse.
- In school-age children,
trauma to the pancreas is quite infrequent and usually involves an injury
caused by bicycle handlebars or traffic accidents. In infants and toddlers
under the age of 3, child abuse must be strongly suspected, since the
pancreas is so deep in the abdomen that it is protected from all trauma
except blunt force trauma.
above is provided to help law enforcement personnel determine which injuries
and illnesses in children are likely to be the result of abuse. However,
it is also very important for law enforcement to work closely with physicians
to determine the nature of all injuries.