Delayed Presentation of Jejuno-Jejunal Fistula With Stricture After Physical Child Abuse. Issue 7 (July 2016)

• Record Type: Journal Article
• Authors: Solaiman, Adil Z.; Kulaylat, Afif N.; Santos, Mary C.; Rocourt, Dorothy V.; Methratta, Sosamma T.; Millington, Karmaine; Alexander, Chandran P.
• Is Part Of: Pediatric emergency care. Volume 32:Issue 7(2016)
• Publication Date: 2016-07
• Subjects: blunt abdominal trauma -- nonaccidental trauma -- child abuse -- delayed presentation -- posttraumatic intestinal stricture; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000000445
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : Abstract: Small intestinal injury is seldom described in the context of child abuse. Signs and symptoms are subtle, often leading to delays in diagnosis. We describe a 3-year-old boy initially admitted with severe blunt abdominal trauma from physical child abuse. He was successfully managed nonoperatively. The child was then hospitalized several times for nonspecific abdominal symptoms until diagnostic laparoscopy discovered a jejunal stricture with a proximal jejuno-jejunal fistula. Symptoms fully resolved after resection. Delayed presentation of small intestinal injury should remain on the differential diagnosis in the evaluation of persistent abdominal symptoms in a child with a prior history of physical abuse, even if imaging studies do not reveal specific abnormalities.