The profile of pediatric patients with physical and sexual abuse in the emergency department

Introduction. Child abuse and neglect is a major worldwide health problem. We set out to assess the incidence, risk factors, as well as the physical and psychological consequences of abuse in children presenting to Emergency Departments with signs of physical aggression. Material and method. We conducted a retrospective study on a sample of 369 children that presented to the Emergency Department of "Sfanta Maria" Clinical Emergency Children's Hospital of Iasi between the 1st of January 2017 and the 31St of December 2017 and were diagnosed with physical aggression. All the patients were assessed from a clinical, biological and imaging point of view, with psychological evaluation and social worker intervention being employed in the selected cases. Results. We identified 24 cases of abused children, 79.1% of the cases entailing physical abuse and 20.8% entailing sexual abuse. The urban/rural ratio was 1:2. The most frequent lesions were cranial-cerebral trauma (70.8%), followed by thoracic contusions 29.1% and abdominal contusions 20.8 %, wounds (45.8%), and 29.1% of cases with polytrauma. 62,5% of the cases were brought to the hospital by the County Ambulance Service. 33.4% of the children came from single parent families, with poor cultural, behavioral and educational levels. Conclusions. Physical and sexual abuse appears to be underrated and under-reported in pediatric Emergency Departments, therefore any suspicion should be carefully assessed. Knowing the specific lesions, along with the careful evaluation of the patients' socio-familial environment are useful instruments in identifying and reporting cases of child abuse.