Shaken Baby Syndrome Suggestive of the Diagnosis of Osteogenesis Imperfecta in Newborn

Yıl 2013, Cilt: 10 Sayı: 3, 173 - 177, 01.09.2013

Ali Annagür Hüseyin Altunhan Bilge Burçak Annagür Sabahattin Ertuğrul Rahmi Örs

Öz

Physical child abuse may occur in a broad range of disorders from a mild soft tissue injury to a severe brain damage leading to death. The head trauma resulted from physical abuse is the main reason for the severe and fatal injuries in children, and arises with the clinical triad of externally seen trauma signs, subdural hemorrhage and retinal hemorrhage. In this article, we report a case of shaken baby aged 20-day, who was referred to our clinic with the diagnosis of late neonatal sepsis and osteogenesis imperfecta. A 20-day-old baby was presented to the emergency department of an outer health center with the complaints of restlessness and non-breastfeeding was considered as sepsis, and subsequently when multiple fractures were detected in the radiological investigations, a diagnosis of osteogenesis imperfecta was also considered, and the baby was referred to our hospital. In the examination of the extremities, he had swelling, ecchymose and limited mobility in both arms and the left calf. The extremity radiograms revealed body fractures in both humeri and the left femur. Radiological investigations are very important for the diagnosis of physical abuse, which causes serious mortality and morbidity and is usually difficult to diagnose because of a wrong medical history given by family members or a history taken by the physician carelessly. Discordance between the history given by the family and the radiological findings should be warning for the physician, and the radiological findings must be assessed carefully.

Anahtar Kelimeler

Shaken baby syndrome, physical child abuse, newborn, osteogenesis imperfecta, multiple fractures

Shaken Baby Syndrome Suggestive of the Diagnosis of Osteogenesis Imperfecta in Newborn

Öz

Fiziksel çocuk istismarı, hafif yumuşak doku yaralanmasından ölüme neden olan ağır beyin hasarına kadar değişen geniş bir yelpazede ortaya çıkabilmektedir. Çocuklarda ciddi ve ölümcül yaralanmaların başlıca nedeni fiziksel istismar sonucu oluşan kafa travmasıdır ve başlıca; dıştan gözlenen travma izleri, subdural hemoraji, retinal hemoraji klinik triadı ile ortaya çıkmaktadır. Yazımızda geç neonatal sepsis ve osteogenezis imperfekta tanısı ile merkezimize sevk edilen 20 günlük bir bebekte hırpalanmış bebek sendromu olgusunu sunduk. Yirmi günlük iken huzursuzluk, emmeme şikâyeti ile dış merkez çocuk acil servisine götürülen hasta sepsis düşünülmüş ve bu sırada çekilen grafilerinde çok sayıda kırık saptanması üzerine, osteogenezis imperfekta tanısı da düşünülerek hastanemize sevk edilmişti. Ekstremite muayenesinde her iki kol ve sol baldırda şişlik, ekimoz ve hareket kısıtlılığı mevcuttu. Ekstremite grafilerinde her iki humerus ve sol femurda cisim kırığı saptandı. Çoğunlukla aile bireyleri tarafından verilen yanlış öykü veya hekimin dikkatsiz aldığı öykü ile tanısı güçleşen, ciddi mortalite ve morbiditeye neden olan fizik istismarın tanısında radyolojik incelemelerin önemi büyüktür. Ailenin verdiği öykü ile radyolojik bulgular arasındaki uyumsuzluk hekim için uyarıcı olmalı ve radyolojik veriler dikkatle incelenmelidir

Anahtar Kelimeler

Hırpalanmış bebek sendromu, fiziksel çocuk istismarı, yenidoğan, osteogenezis imperfekta

Kaynakça

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