Różne formy maltretowania dzieci – przegląd piśmiennictwa

© Borgis - Nowa Pediatria 4/2013, s. 159-163

*Ewa Otto-Buczkowska

Summary
Child abuse frequently is a leading cause of morbidity and mortality in young children and infants. Physical abuse is a significant problem in babies under the age of 1 year. Very young babies, particularly under 6 months old, have the highest risk of suffering damage or death as a result of physical maltreatment. Particular subdural hematoma and fracture as a result of severe abuse, is much more common in babies than in older children.
We suggest that in all forms of child abuse there should be a clear separation of clinical care of the child from forensic and criminal investigations. Children who are abused may present to hospital with a variety of symptoms and signs.
Children who are abused may present to hospital with a variety of symptoms and signs.
The frequency of occult fractures in children with suspicious burns compared with children with other types of physical abuse.
Abusive head injuries are among the most common causes of serious and lethal injuries in children. Relatively high prevalence of occult head injury suggests the need for universal screening of similar high-risk abused children. These injuries may result from impact or shaking or a combination of these mechanisms. These mechanisms cause the child’s head to undergo acceleration-deceleration movements which may create inertial movement of the brain within the cranial compartment.
Screening method for detecting occult head injury should be proceed directly to CT or MRI in high-risk populations. Cranial CT scan or MRI should be incorporated into the work-up of a young child with evidence of nonaccidental trauma to other parts of the body.
Childhood sexual abuse (CSA) is a worldwide problem. Sexual child abuse was found to be higher than previously reported. CSA is strongly associated with experiencing multiple other forms of adverse childhood experiences (ACEs).

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