Paediatricians Sometimes Fail To Diagnose Child Abuse

December 05, 1998

(Subdural haemorrhages in infants: population based study)

(Subdural haemorrhages in infants: almost all are due to abuse but abuse is often not recognised)

This week's BMJ publishes a study of 33 children with subdural haemorrhage in South Wales and south west England. Written by Dr Sandeep Jayawant and colleagues from the University of Wales College of Medicine, and Southmead and Frenchay Hospitals in Bristol, the study finds that in most cases the cause of the injury is abuse. The prognosis for infants suffering these injuries is very poor.

The authors express concern that such cases are not being investigated fully and that the high probability of child abuse is not being recognised. They therefore propose that the clinical investigation of subdural haemorrhages should be more comprehensive.

In an accompanying editorial Ben Lloyd from the Royal Free Hospital in London argues that if British paediatricians do not recognise child abuse, no action will be taken to protect the child and the child's siblings from further assault.


Dr Alison Kemp, Senior Lecturer, Department of Child Health, University of Wales College of Medicine, Academic Centre, Llandough Hospital, Penarth, Vale of Glamorgan

Ben Lloyd, Consultant Paediatrician, Department of Child Health, Royal Free Hospital Hampstead NHS Trust, London


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