17-3-12 Fig 1.png
17-3-12 Fig 2.png
17-3-12 Fig 3.png
17-3-12 Fig 4.png

Multiple Foreign Bodies in a 5-Year Old: Non-Accidental Trauma

Mulewa Mulenga, Patricia Shinondo, Bruce Chikasa Bvulani

University of Zambia University Teaching Hospital, Lusaka, Zambia

Correspondence to: Dr. Mulewa Mulenga; email: mulengamulewa@rocketmail.com

Summary

Foreign bodies, a significant proportion of which are a result of non-accidental trauma, are common but under-reported. Pediatric foreign body injuries can be inconsequential, severe or even fatal, and cause long-lasting morbidity and the need for treatment and hospitalization. Evaluation of injury or death requires elements of detection, pattern recognition, interpretation and comparison, all based on clinical, radiological and forensic experience with normal and abnormal findings. We report an unusual and strange case of non-accidental trauma in a young child who presented to our surgical services with 44 sewing needles and wires in his body. The patient had specific characteristics or risks for abuse. His injuries were evaluated, recognized, documented and reported. He was treated for peritonitis and malnutrition and  the foreign bodies removed using staged operations under image guidance. Patient’s recovery was uneventful.

Keywords: Multiple foreign bodies, Trauma

Ann Afr Surg. 2020;17(3):137–141

DOI: http://dx.doi.org/10.4314/aas.v17i3.12

Conflicts of Interest: None

Funding: None

© 2020 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

Submitted: 7 July 2019

Revised: 27 December 2019

Accepted: 13 February 2020

Online first: 29 May 2020

Introduction

The definition of child abuse has long been argued. Finkelhor was one of many authors to suggest a definition (1). The dimensions for an act to be ‘maltreatment’ include: intentional act, socially censored in locale in which it occurred, abusive according to international consensus, harm to a child rather than an adult (2). According to the Zambian Affiliation and Maintenance of Children Act of 1995, a child is a person below the age of 18 years (3). Though definitions of child abuse are many, our laws define it as any non-accidental behavior by parents, caregivers, other adults and adolescents that is outside the norms of conduct and entails a substantial risk of causing physical or emotional harm to a child. Some forms of negligence or omissions are not an exception (3).

In defense, abusers cite the need to discipline a child as reason for the injury. However, there is a difference between discipline and abuse. Discipline teaches children right from wrong and does not make them live in fear. The opposite is true about child abuse (4).