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: firstname.lastname@example.org
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
Conflicts of Interest: 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
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).