ABSTRACT
Caffey and Kempe first focused the medical community's attention on the problem of child abuse by identifying an association between long-bone fractures and ­subdural hematomas in children. Seriously abused children are often evaluated for an unexplained loss of consciousness or shock. As with any life-threatening injury or clinical situation with hemodynamic instability, standard resuscitative interventions are employed. Fractures are brought to the attention of the physician in three ways: acute evaluation for fracture-related signs and symptoms, incidental discovery of old fractures on another radiographic study, and by skeletal survey. Although the true incidence of abdominal trauma as a result of child abuse is unknown, it is less common than burns, head injuries, and musculoskeletal injuries, and represents less than 1% of all pediatric trauma admissions. The most common mechanism is a direct blow to the mid-epigastrum.
