By Sir Roy Meadow, Jacqueline Mok, Donna Rosenberg

Baby abuse is unforgivable and this e-book pulls no punches in describing what it's and exhibiting the noticeable results. while you're serious about the care of different peoples young ones i will be able to suggest it.

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Life threatening thoracic injuries are much less common than abdominal injuries. Most chest injuries do not have associated bruising, and intrathoracic injuries, other than rib fractures, are rare. 5 2 Extra-abdominal injury NA 65% 100% Major extra-abdominal injury NA 18% NA Delay in care 9% >3 hours 100% >3 hours Mean 13 hours Abdominal bruise NA 2 NA NA=Not available may be severe internal damage. Difficulty with visual diagnosis, the young age of the children involved, and delayed presentation may all be factors contributing to the high morbidity and mortality associated with abusive visceral injury.

The examination must include an inspection of the anogenital region. All injuries must be carefully documented. Photographs are helpful, where available. 6 A 6 week old baby presented to hospital with irritability. Bilateral small subdural haemorrhages were seen on an MRI scan. Skeletal survey showed multiple bilateral rib fractures (a), a transverse fracture of the radius (b), and a metaphyseal fracture of the distal femur (c). 1 Differential diagnoses of subdural haemorrhage in an infant Cause of SDH Comment Trauma Non-accidental head injury Commonest cause; often associated with other inflicted injuries and retinal haemorrhages Accidental head injury May occur in high falls; whiplash injury in major trauma – for example, road traffic accident Minor household falls rarely cause subdural haemorrhage Retinal haemorrhages associated only with severe injury Neurosurgical complications Commonly reported as a postoperative complication of neurosurgery Perinatal Fetal Infrequently reported on fetal ultrasound scans Labour May occur after childbirth, most commonly after instrumental delivery.

Diagnosis of blunt abdominal trauma is particularly difficult (Fig. 1). Abdominal wall bruising is an inconsistent finding, being reported in 12%, 29% and 75% of victim series, and leads to delay in presentation and diagnosis. Hollow visceral injuries often present with vague gastrointestinal complaints. Solid visceral injuries may present with lethargy or coma, secondary to evolving haemorrhagic shock. Gut necrosis or perforation can cause peritonitis. Traumatic pancreatitis often presents with vomiting and may come to attention weeks later due to an obstructive pseudocyst.

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