Evaluation of cases admitted to the pediatric surgery service of Karadeniz Technical University Farabi Hospital due to abdominal trauma between 2019-2022 in terms of child abuse

Introduction and Objective: Trauma poses a high risk of death and illness in the pediatric age group. The preventable nature of a considerable portion of trauma cases in this age group highlights a noteworthy issue. In our study, we aimed to raise awareness about abdominal injuries resulting from trauma, focusing on the period from 2019 to 2022 and the cases admitted to the Pediatric Surgery Department at the Farabi Hospital of Karadeniz Technical University. We examined cases based on various factors such as gender, age, origin, injured organ, presence of multiple traumas, duration of hospital admission, month and year of occurrence, length of hospital stay, physical abuse indicators, presence of genital injuries, psychiatric history, whether the incident was an accident or a preventable situation, the presumed responsible party, type of case, indicators suggesting neglect, trauma history, vital threat, the presence of bone fractures, and whether simple medical interventions could address the injuries. Through this examination, we aimed to shed light on the extent and forensic aspects of abdominal injuries resulting from trauma, fostering awareness regarding child abuse issues. Material and Method: The research has a cross-sectional descriptive study design and was conducted by retrospectively examining the files of cases that presented with abdominal trauma to the Pediatric Surgery Department of KTU Faculty of Medicine Farabi Hospital between 2019 and 2022. The examination involved both electronic and physical records. Results: Out of the 64 cases presenting with abdominal trauma, it was observed that 9 (14.1%) were in the age range of 0-3 years, 11 (17.1%) were in the age range of 4-6 years, 25 (39.1%) were in the age range of 7-11 years, and 19 (29.7%) were in the age range of 12-18 years. Among the 64 cases, 47 (73.4%) were male, and 17 (26.6%) were female. When examining the origin distribution, falls from a height were the most common cause, accounting for 25 cases (39.1%), followed by 18 cases (28.1%) involving bicycle falls. Regarding the distribution of injured organs, it was found that 15 cases (23.4%) had injuries to multiple abdominal organs, 15 cases (23.4%) had liver injuries, and 12 cases (18.8%) had free fluid in the abdomen. It was noted that 35 cases (54.7%) were forensic cases. Neglect-indicating signs were identified in 41 cases (64%). A statistically significant relationship was found between the type of case and indicators suggesting neglect (p=0.014). Conclusion: Pediatric trauma, including the mechanisms of trauma occurrence and child abuse, is a subject that needs to be addressed from a forensic medical perspective. Preventive measures for trauma in the pediatric age group should be organized and reviewed, and healthcare professionals should not forget their legal reporting obligations in cases of forensic traumatic injuries.