Skull and Posterior Rib Fractures with Respiratory Failure caused by Child Abuse
Abstract: Presence of multiple
fractures suggests child abuse. Skull fractures rarely occurred but posterior
rib fractures are commonly found and have high specificity as a radiological
finding in child abuse. A respiratory failure can occur as a result of the
damage to the osseous structure of the thorax that destabilizes the rib cage
and impairs spontaneous breathing mechanism.
Methods: A case report of a 6-month-old boy who presented with
respiratory failure, multiple bilateral parietal and occipital bone fractures,
and also fractures of right rib 5–8. The patient required ventilatory support
for 9 days in the Pediatric Intensive Care Unit, Dr.HasanSadikin General
Hospital.
Results: The patient was on ventilatory support for 9 days, and was given
antibiotics for 2 weeks. Next, the
patient was referred to the High Care Unit (HCU) after the condition was
stabilized, and then referred to the ward, for treatment by the Social
Pediatric Division. The patient was still having issues about his foster care.
Conclusions: Recognition of presence of fractures is important in early
diagnosis and treatment of child abuse.
Keywords: Child abuse,
multiple fractures, respiratory failure
Author: Dzulfikar Djalil
Lukmanul Hakim, Elza Noviani
Journal Code: jpkedokterangg170095
