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[Battered child syndrome. Surgical implications].

INTRODUCTION
Major trauma, specially abdominal and thoracic trauma due to child abuse is a serious, but fortunately infrequent problem which carries unacceptably high mortality.


MATERIAL AND METHODS
We reviewed our experience with childhood trauma due to battered child syndrome in our hospital to learn the extent, circumstances, presentations, and consequences of this kind of events. Our hospital is the most important center for traumatized child care in Mexico.


RESULTS
After our study, mild trauma due to child abuse accounted for 35 and major trauma accounted for 50 cases. In the former group, 10 patients with fractures were observed; 21 were male patients. Children were abused by father or stepfather in the 21 cases, and by the mother in six. There was delay in seeking immediate medical attention treatment in all patients. In the second group, there were ruptures of small bowel in 27, of the colon in four patients, pancreas in three, and esophagus in two. Lung, pleura, bladder, spleen and other anatomic structures also were affected. Five patients died. Similarity between the two patient groups studied indicates both the widespread nature of child abuse and the need to suspect this diagnosis whenever a child is present with unexplained shock or peritonitis, specially if there is anemia or bilious emesis. Delay in diagnosis contributed to mortality.