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Small bowel perforation and fatal peritonitis following a fall in a 21-month-old child

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Abstract

The authors report a case of fatal peritonitis due to small bowel perforation in a 21-month-old female child. Necropsy excluded natural disease and a thorough Coronial investigation concluded that an accidental fall onto a “doorstop” caused the bowel injury. The investigative findings are presented; the discussion address issues of diagnosis and causation/mechanism of injury.

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References

  1. Kurkchubasche AG, Fendya DG, Tracy TF, Silen ML, Weber TR. Blunt intestinal injury in children. Diagnostic and therapeutic considerations. Arch Surg. 1997;132:652–8.

    PubMed  CAS  Google Scholar 

  2. Schimpl G, Schmidt B, Sauer H. Isolated bowel injury in blunt abdominal trauma in childhood. Eur J Pediatr Surg. 1992;2:341–4.

    Article  PubMed  CAS  Google Scholar 

  3. Brown RA, Bass DH, Rode H, Millar AJW, Cywes S. Gastrointestinal tract perforation in children due to blunt abdominal trauma. Br J Surg. 1992;79:522–4.

    Article  PubMed  CAS  Google Scholar 

  4. Cobb LM, Vinocur CD, Wagner CW, Weintraub WH. Intestinal perforation due to blunt trauma in children in an era of increased nonoperative treatment. J Trauma. 1986;26:461–3.

    Article  PubMed  CAS  Google Scholar 

  5. Burney RE, Mueller GL, Coon WW, Thomas EJ, MacKenzie JR. Diagnosis of isolated small bowel injury following blunt abdominal trauma. Ann Emerg Med. 1983;12:71–4.

    Article  PubMed  CAS  Google Scholar 

  6. Huntimer CM, Muret-Wagstaff S, Leland NL. Can falls on stairs result in small intestinal perforations? Pediatrics. 2000;106:301–5.

    Article  PubMed  CAS  Google Scholar 

  7. Wisner DH, Chun Y, Blaisdell FW. Blunt Intestinal Injury. Arch Surg. 1990;125:1319–23.

    PubMed  CAS  Google Scholar 

  8. Holland AJA, Cass DT, Glasson MJ, Pitkin J. Small bowel injuries in children. J Paediatr Child Health. 2000;36:265–9.

    Article  PubMed  CAS  Google Scholar 

  9. Canty TG Sr, Canty TG Jr, Brown C. Injuries of the gastrointestinal tract from blunt trauma in children: A 12 year experience at a designated pediatric trauma center. J Trauma. 1999;46:234–40.

    Article  PubMed  Google Scholar 

  10. Kakos GS, Grosfeld JL, Morse TS. Small bowel injuries in children after blunt abdominal trauma. Ann Surg. 1971;174:238–41.

    PubMed  CAS  Google Scholar 

  11. Dickinson SJ, Shaw A, Santulli TV. Rupture of the gastrointestinal tract in children by blunt trauma. Surg Gynecol Obstet. 1970;130:655–7.

    PubMed  CAS  Google Scholar 

  12. Pokorney WJ, Brandt ML, Harberg FJ. Major duodenal injuries in children: diagnosis, operative management and outcome. J Pediatr Surg. 1986;21:613–6.

    Article  Google Scholar 

  13. Tank ES, Eraklis AJ, Gross RE. Blunt abdominal trauma in infancy and childhood. J Trauma. 1968;8:439–48.

    Article  PubMed  CAS  Google Scholar 

  14. Grosfeld JL, Molinari F, Chaet M, Engum SA, West KW, Rescorla FJ, Tres Scherer LR III. Gastrointestinal perforation and peritonitis in infants and children: experience with 179 cases over ten years. Surgery. 1996;120:650–6.

    Article  PubMed  CAS  Google Scholar 

  15. Chambers CE. Perforation of the ileum. Arch Surg. 1972;105:550–2.

    PubMed  CAS  Google Scholar 

  16. Hinkamp JF, Byrne MP, De Bartola HM Jr. Perforation of the ileum in a child. J Pediatr Surg. 1974;9:253–4.

    Article  PubMed  CAS  Google Scholar 

  17. Larson HE, Barclay FE, Honour P, Hill ID. Epidemiology of Clostridium difficile in infants. J Infect Dis. 1982;146:727–33.

    PubMed  CAS  Google Scholar 

  18. Oguz F, Uysal G, Dasdemir S, Oskovi H, Vidinlisan S. The role of Clostridium difficile in childhood nosocomial diarrhea. Scand J Infect Dis. 2001;33:731–3.

    Article  PubMed  CAS  Google Scholar 

  19. Stevens SL, Maull KI. Small bowel injuries. Surg Clin North Am. 1990;70:541–61.

    PubMed  CAS  Google Scholar 

  20. Shuck JM, Lowe RJ. Intestinal disruption due to blunt abdominal trauma. Am J Surg. 1978;136:668–73.

    Article  PubMed  CAS  Google Scholar 

  21. Ceelen W, Hesse U, De Hemptinne B. Small bowel perforation following blunt abdominal trauma. Acta Chir Belg. 1995;95:187–9.

    PubMed  CAS  Google Scholar 

  22. Arcari FA. Blunt abdominal trauma in infants and children. J Mich State Med Soc. 1962;61:335–6.

    Google Scholar 

  23. Scalea T, Goldstein A, Phillips T, Sclafani SJA, Panetta T, McAuley J, Shaftan G. An analysis of 161 falls from a height: The “Jumper Syndrome”. J Trauma. 1986;26:706–12.

    Article  PubMed  CAS  Google Scholar 

  24. Bloom AI, Reissman P, Eid A, Durst AL. Isolated ileal perforation after minor blunt abdominal injury. Eur J Surg. 1995;161:57–8.

    PubMed  CAS  Google Scholar 

  25. Mercer S, Legrand L, Stringel G, Soucy P. Delay in diagnosing gastrointestinal injury after blunt abdominal trauma in children. Can J Surg. 1985;28:138–40.

    PubMed  CAS  Google Scholar 

  26. Ross WB, Bickerstaff DR. Late jejunal perforation following blunt injury. Injury. 1985;16:481.

    Article  PubMed  CAS  Google Scholar 

  27. Shenk WG III, Lonchyna V, Moylan JA. Perforation of the jejunum from blunt abdominal trauma. J Trauma. 1983;23:54–6.

    Article  Google Scholar 

  28. Robbs JV, Moore SW, Pillay SP. Blunt abdominal trauma with jejunal injury: a review. J Trauma. 1980;20:308–11.

    PubMed  CAS  Google Scholar 

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Acknowledgment

We are grateful to HM Coroner and the parents of the deceased for permission to report this case.

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Correspondence to Andrew M. Davison.

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Davison, A.M., Lazda, E.J. Small bowel perforation and fatal peritonitis following a fall in a 21-month-old child. Forensic Sci Med Pathol 4, 250–254 (2008). https://doi.org/10.1007/s12024-008-9041-0

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  • DOI: https://doi.org/10.1007/s12024-008-9041-0

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