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Review
. 2025 Aug 2.
doi: 10.1007/s00247-025-06335-x. Online ahead of print.

Imaging and clinical features of intra-abdominal injuries in children with suspected physical abuse

Tagrid M Ruiz-Maldonado  1   2 , M Katherine Henry  3   4 , Esther Ro  5   6 , Shashank S Prasad  7 , Anna Kalathil Thomas  8   9
Affiliations
Review

Imaging and clinical features of intra-abdominal injuries in children with suspected physical abuse

Tagrid M Ruiz-Maldonado et al. Pediatr Radiol. .

Abstract

The effective diagnosis and management of inflicted intra-abdominal injuries require a comprehensive, collaborative evaluation that includes a thorough understanding of the clinical presentation, laboratory findings, injury mechanisms, and potential clinical outcomes. This review presents the various aspects of inflicted intra-abdominal injuries, including the clinical presentation, mechanisms of injury, and the utility of available screening and imaging tools. The specific types of solid organ and hollow viscus injuries relevant to child physical abuse and their imaging appearance are also discussed. Radiological imaging provides critical information that can help treating providers contextualize the history obtained and the injuries identified, highlighting the value of close collaboration among radiologists, child abuse pediatricians, and other members of the clinical team when concerns for abuse arise.

Keywords: Abdomen; Child; Diagnostic imaging; Infant; Injuries; Physical abuse.

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Conflict of interest statement

Declarations. Competing interests: Dr. Ruiz-Maldonado and Dr. Henry have provided testimony in cases with concern for child maltreatment for which their institutions received payment.

References

    1. U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2021). Child Maltreatment 2019. Available from https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/...
    1. Leventhal JM, Martin KD, Gaither JR (2012) Using US data to estimate the incidence of serious physical abuse in children. Pediatrics 129:458–464
    1. Lindberg D, Makoroff K, Harper N et al (2009) Utility of hepatic transaminases to recognize abuse in children. Pediatrics 124:509–516
    1. Lindberg DM, Shapiro RA, Blood EA et al (2013) Utility of hepatic transaminases in children with concern for abuse. Pediatrics 131:268–275
    1. Maguire SA, Upadhyaya M, Evans A et al (2013) A systematic review of abusive visceral injuries in childhood–their range and recognition. Child Abuse Negl 37:430–445

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