Beckmann K, Nozicka C. Small bowel perforation: an unusual presentation for child abuse. J Am Osteopath Assoc 2000;100(8):496-497. doi: 10.7556/jaoa.2000.100.8.496.
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Hollow viscus perforation due to inflicted blunt abdominal injury is uncommon. Diagnosis is frequently delayed because of inaccurate or absent history, nonspecific or delayed physical findings or both, and laboratory tests with low sensitivity. Computed tomographic scanning of the abdomen is the best diagnostic test available. A high index of suspicion is essential to diagnose visceral perforation early, as significant morbidity and mortality results from diagnostic delay.
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