Romo-Conrique V, Zepeda-Romero C, Avilés-Martínez KI, López-Enríquez A, Aguirre-Jáuregui Ó

Language: Spanish
References: 11
Page: 201-205
PDF size: 816.36 Kb.

ABSTRACT

Introduction. Child abuse has unspecific signs and symptoms complicating a precise and quick diagnostic. 30% of the victims of accidental trauma present ophthalmological manifestations, from that, 77-88% correspond to retinal hemorrhages; other manifestations in child abuse can be associated with malnutrition (Conjunctival and corneal xerosis , Bitot's spots, keratomalacia, endophthalmitis), anemia (anemic retinopathy), retinal hemorrhages and cotton-wool exudates.
Material y Methods. Descriptive transversal study. Simple random statistical sampling, n=100 children, both genders ranging from 1 to 48 months old admitted to the pediatrics emergency in the Fray Antonio Alcalde Civil Hospital from June to November 2012. A tool was designed for the study and divided into four parts as follows: A) Clinical data, admittance diagnostic, vital signs and previous admittances; B) Directed interrogatory; C) Child Abuse Potential Inventory (CAPI) evaluating the parents; D) Ophthalmologic evaluation.
Results. 38% were female, 62% males. 3% presented hemorrhages in fundus of eye. The rate of prevalence of ophthalmological findings with suspicion of child abuse was 12 per 10,000; the prevalence of ophthalmological abnormalities was 3 per 100 children. The positive clinical criteria for suspicion of child abuse was grouped on digestive signs (f=32%), respiratory signs (f=69%) and neurological signs (62%), 100% specificity, r=75%. The CAP inventory showed a low correlation with r=1.78%, 48% sensitivity, 57% specificity.
Discussion. The diagnosis of child abuse requires a high level of suspicion, detailed physical exploration and a complete anamnesis more than once. One of the best indicators of abuse is the systematic check-up in the fundus of eye in all patients in search for abnormalities hinting the pathology.

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