Life-threatening Child Abuse: Penetrating Injury of Abdomen with Sewing Needles.

A 14-month-old girl weighing 5 kg was brought to the casualty services of our hospital by her mother with complaints of pain in the abdomen and persistent crying. The mother informed the physicians of her suspicion of rodent-bite while she was away doing household chores. A careful examination revealed a single pin-head sized puncture mark in the epigastric region. A sharp tip of a single foreign body was palpable just below the puncture mark. There were no external injuries over rest of the abdomen. A plain abdominal radiograph showed three linear foreign bodies (Fig. 1a). On lateral films, the objects appeared to be intra-abdominal, traversing more than half of the depth of the abdomen (Fig. 1b). It then became clear that all three linear objects were inserted one after the other, through a single puncture site in epigastrium. A medicolegal case was registered. An exploratory laparotomy was undertaken and the first foreign body, identified as rusted sewing needle, was retrieved from the sub-hepatic region, entangled within the omentum. The other two, which were embedded deep within the liver parenchyma with just the tips on liver surface, were retrieved through a separate incision. Rest of the solid organs and bowel were normal. Postoperative period was uneventful and patient was discharged after completing medicolegal procedures. Life-threatening Child Abuse: Penetrating Injury of Abdomen with Sewing Needles