Child Abuse—A Review of Inflicted Intraoral, Esophageal, and Abdominal Visceral Injuries

Recognizing the clinical presentation of a child with abusive injuries is crucial. This review article gives an updated summary on inflicted intraoral, esophageal, and abdominal visceral injuries, including current recommendations on recognition, evaluation, screening value, and management of at risk children. Physical abuse should be suspected in precruising infants with intraoral injuries. When sexual abuse is suspected, referral to specialized centers equipped to conduct comprehensive examination and forensic testing by an experienced provider adhering to chain of evidence protocol is recommended. Abdominal trauma is the second most common cause of death in children who have been abused. The diagnosis and management of these injuries require careful consideration. Routine screening hepatic transaminases should be guided by the age of child and clinical scenario. A definitive confirmatory computed tomography scan of the abdomen and pelvis should be performed for those with transaminase levels more than 80 IU/L, or in all concerning cases with history and examination consistent with abusive abdominal trauma.