Severe physical abuse with admission to Pediatric Intensive Care Unit

Abstract

Introduction. 
Child abuse is a problem of public health. Several reports have demonstrated an increasing tendency for this problem. The objective of this study is to describe cases of severe child abuse admitted to paediatric intensive care unit (PICU).

Methods. 
This is a retrospective study (1995-2011) in which patients diagnosed with physical child abuse admitted to PICU were included. Epidemiological and clinical findings, diagnostic procedures and therapy were analyzed. 

Results. 
Eight patients were included with a median age of 7 months. The most frequent sign was neurological. The more frequent injuries associated were subdural haematoma (6 patients), retinal haemorrhages (4 patients), severe abnormality in electroencephalogram (3 patients), skull fracture (3 patients), other fractures (2 patients). Finally, there was one death and two cases of severe neurological damage. 

Conclusion.
Child abuse can be falsely diagnosed as a neurological disease. Pediatricians should be aware of this pathology in order to identify cases of abuse as soon as possible. The relevance of early diagnosis is based on the fact that an early intervention could prevent severe sequelae or death.