Citation

Vellody K, Freeto JP, Gage SL, Collins N, Gershan WM. Clin. Pediatr. 2008; 47(9): 912-918.

Affiliation

Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA. kishore.vellody@chp.edu

Copyright

(Copyright © 2008, SAGE Publishing)

DOI

10.1177/0009922808320595

PMID

18648082

Abstract

BACKGROUND: Apparent life-threatening events (ALTEs) can encompass many different diagnoses. Nonaccidental trauma (NAT) is one potential serious diagnosis. OBJECTIVE: (1) To identify key elements in the history and physical exam in infants presenting with an ALTE that aid in the subsequent diagnosis of NAT; and (2) to evaluate the role of diagnostic studies in these infants in confirming the diagnosis of NAT. DESIGN/METHODS: A retrospective chart review analysis, over a 2-year period, of infants with an ALTE was performed. From this group, all children with a discharge diagnosis of child physical abuse, shaken infant syndrome, or NAT were included in the study. RESULTS: 4 patients were found to be victims of NAT based on their clinical histories and physical examinations. Although confirmatory, ophthalmologic exams, skeletal surveys, and head CT scans had a lower sensitivity for NAT. CONCLUSIONS: NAT should be considered when an infant is admitted for evaluation of an ALTE.

Language: en