Traumatic injuries to the duodenum may occur during episodes of blunt trauma in child abuse.
Types of injuries may include:
(1) intramural hematoma
(2) perforation
(3) transection
The challenge is to distinguish abuse from other causes of blunt trauma in children (bicycle, motor vehicle, ATV, soccer, etc).
Gaines et al found that duodenal injuries in children < 4 years of age were often due to abusive injuries.
Other reasons to suspect abuse:
(1) history of physical abuse or neglect
(2) other injuries compatible with abuse
(3) exclusion of other causes of blunt trauma
Complications:
(1) stricture with potential for bowel obstruction
(2) abscess and sepsis
The outcome of perforation or transection is poor if care is delayed due to neglect.
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Specialty: Clinical Laboratory, Pedatrics, Gastroenterology
