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Pediatric emergency care · Jul 2016
Case ReportsDelayed Presentation of Jejuno-Jejunal Fistula With Stricture After Physical Child Abuse.
- Adil Z Solaiman, Afif N Kulaylat, Mary C Santos, Dorothy V Rocourt, Sosamma T Methratta, Karmaine Millington, and Chandran P Alexander.
- From the *Department of Pediatrics, Divisions of †Pediatric Surgery, ‡Pediatric Radiology, and §Anatomic Pathology, Penn State Hershey Medical Center, Hershey, PA.
- Pediatr Emerg Care. 2016 Jul 1; 32 (7): 462-4.
AbstractSmall 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.
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