{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:44:14Z","timestamp":1777891454288,"version":"3.51.4"},"reference-count":66,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services","award":["K08HS028847"],"award-info":[{"award-number":["K08HS028847"]}]},{"DOI":"10.13039\/100006034","name":"University of Southern California","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006034","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The effective diagnosis and management of inflicted intra-abdominal injuries require a comprehensive, collaborative evaluation that includes a thorough understanding of the clinical presentation, laboratory findings, injury mechanisms, and potential clinical outcomes. This review presents the various aspects of inflicted intra-abdominal injuries, including the clinical presentation, mechanisms of injury, and the utility of available screening and imaging tools. The specific types of solid organ and hollow viscus injuries relevant to child physical abuse and their imaging appearance are also discussed. Radiological imaging provides critical information that can help treating providers contextualize the history obtained and the injuries identified, highlighting the value of close collaboration among radiologists, child abuse pediatricians, and other members of the clinical team when concerns for abuse arise.<\/jats:p>","DOI":"10.1007\/s00247-025-06335-x","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T10:17:18Z","timestamp":1754129838000},"page":"992-1007","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Imaging and clinical features of intra-abdominal injuries in children with suspected physical abuse"],"prefix":"10.1007","volume":"56","author":[{"given":"Tagrid M.","family":"Ruiz-Maldonado","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Katherine","family":"Henry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Ro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shashank S.","family":"Prasad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Kalathil","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"key":"6335_CR1","unstructured":"U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children\u2019s Bureau. (2021). Child Maltreatment 2019. Available from https:\/\/www.acf.hhs.gov\/cb\/research-data-technology\/statistics-research\/child-maltreatment"},{"key":"6335_CR2","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1542\/peds.2011-1277","volume":"129","author":"JM Leventhal","year":"2012","unstructured":"Leventhal JM, Martin KD, Gaither JR (2012) Using US data to estimate the incidence of serious physical abuse in children. Pediatrics 129:458\u2013464","journal-title":"Pediatrics"},{"key":"6335_CR3","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1542\/peds.2008-2348","volume":"124","author":"D Lindberg","year":"2009","unstructured":"Lindberg D, Makoroff K, Harper N et al (2009) Utility of hepatic transaminases to recognize abuse in children. Pediatrics 124:509\u2013516","journal-title":"Pediatrics"},{"key":"6335_CR4","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1542\/peds.2012-1952","volume":"131","author":"DM Lindberg","year":"2013","unstructured":"Lindberg DM, Shapiro RA, Blood EA et al (2013) Utility of hepatic transaminases in children with concern for abuse. Pediatrics 131:268\u2013275","journal-title":"Pediatrics"},{"key":"6335_CR5","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.chiabu.2012.10.009","volume":"37","author":"SA Maguire","year":"2013","unstructured":"Maguire SA, Upadhyaya M, Evans A et al (2013) A systematic review of abusive visceral injuries in childhood\u2013their range and recognition. Child Abuse Negl 37:430\u2013445","journal-title":"Child Abuse Negl"},{"key":"6335_CR6","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1016\/j.jpedsurg.2015.10.056","volume":"51","author":"KW Carter","year":"2016","unstructured":"Carter KW, Moulton SL (2016) Pediatric abdominal injury patterns caused by \u201cfalls\u201d: a comparison between nonaccidental and accidental trauma. J Pediatr Surg 51:326\u2013328","journal-title":"J Pediatr Surg"},{"key":"6335_CR7","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.chiabu.2011.09.010","volume":"36","author":"WG Lane","year":"2012","unstructured":"Lane WG, Dubowitz H, Langenberg P et al (2012) Epidemiology of abusive abdominal trauma hospitalizations in United States children. Child Abuse Negl 36:142\u2013148","journal-title":"Child Abuse Negl"},{"key":"6335_CR8","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1177\/1077559503260310","volume":"9","author":"M Trokel","year":"2004","unstructured":"Trokel M, DiScala C, Terrin NC et al (2004) Blunt abdominal injury in the young pediatric patient: child abuse and patient outcomes. Child Maltreat 9:111\u2013117","journal-title":"Child Maltreat"},{"key":"6335_CR9","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1007\/s00247-010-1899-9","volume":"41","author":"MA Hilmes","year":"2011","unstructured":"Hilmes MA, Hernanz-Schulman M, Greeley CS et al (2011) CT identification of abdominal injuries and abused pre-school-aged children. Pediatr Radiol 41:643\u2013651","journal-title":"Pediatr Radiol"},{"key":"6335_CR10","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1016\/j.amjsurg.2005.05.049","volume":"190","author":"JB Roaten","year":"2005","unstructured":"Roaten JB, Patrick DA, Bensard DD et al (2005) Visceral injuries in nonaccidental trauma: spectrum of injury and outcomes. Am J Surg 190:827\u2013829","journal-title":"Am J Surg"},{"key":"6335_CR11","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1097\/01.ta.0000196437.07011.b1","volume":"59","author":"J Wood","year":"2005","unstructured":"Wood J, Rubin DM, Nance ML et al (2005) Distinguishing inflicted versus accidental abdominal injuries in young children. J Trauma 59:1203\u20131208","journal-title":"J Trauma"},{"key":"6335_CR12","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1097\/TA.0000000000001441","volume":"82","author":"MA Escobar","year":"2017","unstructured":"Escobar MA, Flynn-O\u02bcBrien KT, Auerbach M et al (2017) The association of nonaccidental trauma with historical factors, examination findings, and diagnostic testing during the initial trauma evaluation. J Trauma Acute Care Surg 82:1147\u20131157","journal-title":"J Trauma Acute Care Surg"},{"key":"6335_CR13","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s10140-024-02305-2","volume":"32","author":"B Karmazyn","year":"2025","unstructured":"Karmazyn B, Fisher RS, Alcaide DM et al (2025) Comparison of clinical and abdominal CT imaging findings in children evaluated for abusive and accidental abdominal trauma. Emerg Radiol 32:23\u201331","journal-title":"Emerg Radiol"},{"key":"6335_CR14","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1148\/rg.341135013","volume":"34","author":"EF Sheybani","year":"2014","unstructured":"Sheybani EF, Gonzalez-Araiza G, Kousari YM et al (2014) Pediatric non accidental abdominal trauma: what the radiologist should know. Radiographics 34:139\u2013153","journal-title":"Radiographics"},{"key":"6335_CR15","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.cpem.2006.05.003","volume":"7","author":"S Herr","year":"2006","unstructured":"Herr S, Fallat ME (2006) Abusive abdominal and thoracic trauma. Clin Pediatr Emerg Med 7:149\u2013152","journal-title":"Clin Pediatr Emerg Med"},{"key":"6335_CR16","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1097\/PEC.0b013e3181fe9139","volume":"26","author":"SB Haney","year":"2010","unstructured":"Haney SB, Starling SP, Heisler KW, Okwara L (2010) Characteristics of falls and risk of injury in children younger than 2 years. Pediatr Emerg Care 26:914\u2013918","journal-title":"Pediatr Emerg Care"},{"key":"6335_CR17","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/S0140-6736(05)66913-9","volume":"366","author":"PM Barnes","year":"2005","unstructured":"Barnes PM, Norton CM, Dunston FD et al (2005) Abdominal injury due to child abuse. Lancet 366:234\u2013235","journal-title":"Lancet"},{"key":"6335_CR18","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1542\/peds.106.2.301","volume":"106","author":"CM Huntimer","year":"2000","unstructured":"Huntimer CM, Muret-Wagstaff S, Leland NL (2000) Can falls on stairs result in small intestine perforations? Pediatrics 106:301\u2013305","journal-title":"Pediatrics"},{"key":"6335_CR19","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.annemergmed.2012.11.009","volume":"62","author":"JF Holmes","year":"2013","unstructured":"Holmes JF, Lillis K, Monroe D et al (2013) Identifying children at very low risk of clinically important blunt abdominal injuries. Ann Emerg Med 62:107\u2013116.e102","journal-title":"Ann Emerg Med"},{"key":"6335_CR20","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.annemergmed.2013.02.031","volume":"62","author":"DM Lindberg","year":"2013","unstructured":"Lindberg DM, Berger RP, Lane WG (2013) Pecarn abdominal injury rule should exclude potentially abused children. Ann Emerg Med 62:276\u2013277","journal-title":"Ann Emerg Med"},{"issue":"5","key":"6335_CR21","doi-asserted-by":"publisher","first-page":"e1337","DOI":"10.1542\/peds.2015-0356","volume":"135","author":"CW Christian","year":"2015","unstructured":"Christian CW, Committee on Child Abuse and Neglect American Academy of Pediatrics (2015) The evaluation of suspected child physical abuse. Pediatrics 135(5):e1337\u20131354","journal-title":"Pediatrics"},{"key":"6335_CR22","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1097\/TA.0000000000004329","volume":"97","author":"JY Lee","year":"2024","unstructured":"Lee JY, Coombs C, Clarke J, Berger R (2024) Aspartate aminotransferase and alanine aminotransferase elevation in suspected physical abuse: can the threshold to obtain an abdominal computed tomography be raised? J Trauma Acute Care Surg 97:294\u2013298","journal-title":"J Trauma Acute Care Surg"},{"key":"6335_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1542\/pedsos.2024-000274","volume":"1","author":"TM Ruiz-Maldonado","year":"2025","unstructured":"Ruiz-Maldonado TM, Wood JN, Laskey AL et al (2025) Occult abdominal trauma screening in the evaluation of suspected child physical abuse. Pediatrics Open Science 1:1\u201312","journal-title":"Pediatrics Open Science"},{"key":"6335_CR24","doi-asserted-by":"publisher","first-page":"104714","DOI":"10.1016\/j.chiabu.2020.104714","volume":"109","author":"K Fortin","year":"2020","unstructured":"Fortin K, Wood JN (2020) Utility of screening urinalysis to detect abdominal injuries in suspected victims of child physical abuse. Child Abuse Negl 109:104714","journal-title":"Child Abuse Negl"},{"key":"6335_CR25","doi-asserted-by":"publisher","first-page":"S338","DOI":"10.1016\/j.jacr.2017.01.036","volume":"14","author":"SL Wootton-Gorges","year":"2017","unstructured":"Wootton-Gorges SL, Soares BP, Alazraki AL et al (2017) ACR appropriateness criteria\u00ae suspected physical abuse-child. J Am Coll Radiol 14:S338\u2013S349","journal-title":"J Am Coll Radiol"},{"key":"6335_CR26","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1542\/peds.2009-0558","volume":"123","author":"Section on Radiology; American Academy of Pediatrics","year":"2009","unstructured":"Section on Radiology; American Academy of Pediatrics (2009) Diagnostic imaging of child abuse. Pediatrics 123:1430\u20131435","journal-title":"Pediatrics"},{"key":"6335_CR27","first-page":"402","volume":"21","author":"P Bombi\u0144ski","year":"2017","unstructured":"Bombi\u0144ski P, Brzewski M, Warcho\u0142 S et al (2017) One-phase split-bolus CT urography - a novel approach to reduce radiation dose in diagnostics of congenital anomalies of kidneys and urinary tract in children. Dev Period Med 21:402\u2013407","journal-title":"Dev Period Med"},{"key":"6335_CR28","doi-asserted-by":"publisher","first-page":"314","DOI":"10.2214\/AJR.07.2288","volume":"189","author":"LC Chow","year":"2007","unstructured":"Chow LC, Kwan SW, Olcott EW et al (2007) Split-bolus MDCT urography with synchronous nephrographic and excretory phase enhancement. AJR Am J Roentgenol 189:314\u2013322","journal-title":"AJR Am J Roentgenol"},{"key":"6335_CR29","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/j.amjsurg.2020.01.006","volume":"220","author":"OA Odia","year":"2020","unstructured":"Odia OA, Yorkgitis B, Gurien L et al (2020) An evidence-based algorithm decreases computed tomography use in hemodynamically stable pediatric blunt abdominal trauma patients. Am J Surg 220:482\u2013488","journal-title":"Am J Surg"},{"key":"6335_CR30","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.2214\/ajr.174.6.1741613","volume":"174","author":"EC Benya","year":"2000","unstructured":"Benya EC, Lim-Dunham JE, Landrum O et al (2000) Abdominal sonography in examination of children with blunt abdominal trauma. AJR Am J Roentgenol 174:1613\u20131616","journal-title":"AJR Am J Roentgenol"},{"key":"6335_CR31","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.1016\/j.jpedsurg.2007.04.023","volume":"42","author":"JF Holmes","year":"2007","unstructured":"Holmes JF, Gladman A, Chang CH (2007) Performance of abdominal ultrasonography in pediatric blunt trauma patients: a meta-analysis. J Pediatr Surg 42:1588\u20131594","journal-title":"J Pediatr Surg"},{"key":"6335_CR32","doi-asserted-by":"publisher","first-page":"557.e1","DOI":"10.1016\/j.jpurol.2020.04.020","volume":"16","author":"A Edwards","year":"2020","unstructured":"Edwards A, Hammer M, Artunduaga M et al (2020) Renal ultrasound to evaluate for blunt renal trauma in children: a retrospective comparison to contrast enhanced CT imaging. J Pediatr Urol 16:557.e1\u2013557.e7","journal-title":"J Pediatr Urol"},{"key":"6335_CR33","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/S0720-048X(03)00145-1","volume":"51","author":"F Ta\u015f","year":"2004","unstructured":"Ta\u015f F, Ceran C, Atalar MH et al (2004) The efficacy of ultrasonography in hemodynamically stable children with blunt abdominal trauma: a prospective comparison with computed tomography. Eur J Radiol 51:91\u201396","journal-title":"Eur J Radiol"},{"key":"6335_CR34","doi-asserted-by":"publisher","first-page":"4446","DOI":"10.1038\/s41598-017-04779-2","volume":"7","author":"Z Zhang","year":"2017","unstructured":"Zhang Z, Hong Y, Liu N et al (2017) Diagnostic accuracy of contrast enhanced ultrasound in patients with blunt abdominal trauma presenting to the emergency department: a systematic review and meta-analysis. Sci Rep 7:4446","journal-title":"Sci Rep"},{"key":"6335_CR35","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1007\/s11547-015-0535-z","volume":"120","author":"G Menichini","year":"2015","unstructured":"Menichini G, Sessa B, Trinci M et al (2015) Accuracy of contrast-enhanced ultrasound (CEUS) in the identification and characterization of traumatic solid organ lesions in children: a retrospective comparison with baseline US and CE-MDCT. Radiol Med 120:989\u20131001","journal-title":"Radiol Med"},{"key":"6335_CR36","doi-asserted-by":"publisher","first-page":"2253","DOI":"10.1007\/s00247-020-04869-w","volume":"51","author":"HJ Paltiel","year":"2021","unstructured":"Paltiel HJ, Barth RA, Bruno C et al (2021) Contrast-enhanced ultrasound of blunt abdominal trauma in children. Pediatr Radiol 51:2253\u20132269","journal-title":"Pediatr Radiol"},{"key":"6335_CR37","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11547-014-0455-3","volume":"120","author":"F Pinto","year":"2015","unstructured":"Pinto F, Valentino M, Romanini L et al (2015) The role of CEUS in the assessment of haemodynamically stable patients with blunt abdominal trauma. Radiol Med 120:3\u201311","journal-title":"Radiol Med"},{"key":"6335_CR38","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1136\/bmj.39534.686192.80","volume":"336","author":"JO Jansen","year":"2008","unstructured":"Jansen JO, Yule SR, Loudon MA (2008) Investigation of blunt abdominal trauma. BMJ 336:938\u2013942","journal-title":"BMJ"},{"key":"6335_CR39","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1007\/s00247-010-1882-5","volume":"41","author":"M Raissaki","year":"2011","unstructured":"Raissaki M, Veyrac C, Blondiaux E et al (2011) Abdominal imaging in child abuse. Pediatr Radiol 41:4\u201316","journal-title":"Pediatr Radiol"},{"key":"6335_CR40","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1053\/j.ro.2007.08.009","volume":"43","author":"SD Bixby","year":"2008","unstructured":"Bixby SD, Callahan MJ, Taylor G (2008) Imaging in pediatric blunt abdominal trauma. Semin Roentgenol 43:72\u201382","journal-title":"Semin Roentgenol"},{"key":"6335_CR41","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/j.jamcollsurg.2008.06.342","volume":"207","author":"G Tinkoff","year":"2008","unstructured":"Tinkoff G, Esposito TJ, Reed J et al (2008) American Association for the Surgery of Trauma organ injury scale I: spleen, liver, and kidney, validation based on the National Trauma Data Bank. J Am Coll Surg 207:646\u2013655","journal-title":"J Am Coll Surg"},{"key":"6335_CR42","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s10140-017-1515-5","volume":"24","author":"JA Graves","year":"2017","unstructured":"Graves JA, Hanna TN, Herr KD (2017) Pearls and pitfalls of hepatobiliary and splenic trauma: what every trauma radiologist needs to know. Emerg Radiol 24:557\u2013568","journal-title":"Emerg Radiol"},{"key":"6335_CR43","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.injury.2005.07.013","volume":"37","author":"A Landau","year":"2006","unstructured":"Landau A, van As AB, Numanoglu A et al (2006) Liver injuries in children: the role of selective non-operative management. Injury 37:66\u201371","journal-title":"Injury"},{"key":"6335_CR44","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.jvir.2020.11.024","volume":"32","author":"K Shinn","year":"2021","unstructured":"Shinn K, Gilyard S, Chahine A et al (2021) Contemporary management of pediatric blunt splenic trauma: a National Trauma Databank analysis. J Vasc Interv Radiol 32:692\u2013702","journal-title":"J Vasc Interv Radiol"},{"key":"6335_CR45","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ejrad.2006.03.010","volume":"59","author":"D Bosboom","year":"2006","unstructured":"Bosboom D, Braam AWE, Blickman JG et al (2006) The role of imaging studies in pancreatic injury due to blunt abdominal trauma in children. Eur J Radiol 59:3\u20137","journal-title":"Eur J Radiol"},{"key":"6335_CR46","doi-asserted-by":"publisher","first-page":"415","DOI":"10.4329\/wjr.v7.i11.415","volume":"7","author":"M Moshetta","year":"2015","unstructured":"Moshetta M, Telegrafo M, Malagnino V et al (2015) Pancreatic trauma: the role of computed tomography for guiding therapeutic approach. World J Radiol 7:415\u2013420","journal-title":"World J Radiol"},{"key":"6335_CR47","doi-asserted-by":"publisher","first-page":"135","DOI":"10.3390\/children11010135","volume":"11","author":"I Sukhotnik","year":"2024","unstructured":"Sukhotnik I, Cohen N (2024) Management of blunt pancreatic trauma in children: a persistent controversy- case report and comprehensive literature review. Children 11:135","journal-title":"Children"},{"key":"6335_CR48","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1148\/rg.286085524","volume":"28","author":"U Linsenmaier","year":"2008","unstructured":"Linsenmaier U, Wirth S, Reiser M et al (2008) Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology. Radiographics 28:1591\u20131601","journal-title":"Radiographics"},{"key":"6335_CR49","doi-asserted-by":"publisher","first-page":"151085","DOI":"10.1016\/j.sempedsurg.2021.151085","volume":"30","author":"G Singer","year":"2021","unstructured":"Singer G, Arneitz C, Tschauner S et al (2021) Trauma in pediatric urology. Semin Pediatr Surg 30:151085","journal-title":"Semin Pediatr Surg"},{"key":"6335_CR50","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1097\/PEC.0b013e31819e375b","volume":"25","author":"T Lautz","year":"2009","unstructured":"Lautz T, Leonhardt D, Rowell E et al (2009) Intraperitoneal bladder rupture as an isolated manifestation of nonaccidental trauma in a child. Pediatr Emerg Care 25:260\u2013262","journal-title":"Pediatr Emerg Care"},{"key":"6335_CR51","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1097\/00006565-200204000-00007","volume":"18","author":"JW Yang","year":"2002","unstructured":"Yang JW, Kuppermann N, Rosas A (2002) Child abuse presenting as pseudorenal failure with a history of a bicycle fall. Pediatr Emerg Care 18:91\u201392","journal-title":"Pediatr Emerg Care"},{"key":"6335_CR52","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s003830050037","volume":"16","author":"SJ deRoux","year":"2000","unstructured":"deRoux SJ, Prendergast NC (2000) Adrenal lacerations in child abuse: a marker of severe trauma. Pediatr Surg Int 16:121\u2013123","journal-title":"Pediatr Surg Int"},{"key":"6335_CR53","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1148\/radiology.173.3.2813769","volume":"173","author":"CJ Sivit","year":"1989","unstructured":"Sivit CJ, Taylor GA, Eichelberger MR (1989) Visceral injury in battered children: a changing perspective. Radiology 173:659\u2013661","journal-title":"Radiology"},{"key":"6335_CR54","doi-asserted-by":"publisher","first-page":"661","DOI":"10.2214\/ajr.162.3.8109518","volume":"162","author":"K Nimkin","year":"1994","unstructured":"Nimkin K, Teeger S, Wallach MT et al (1994) Adrenal hemorrhage in abused children: imaging and postmortem findings. AJR Am J Roentgenol 162:661\u2013663","journal-title":"AJR Am J Roentgenol"},{"key":"6335_CR55","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1097\/01.ju.0000155459.11926.61","volume":"173","author":"L Gabal-Shehab","year":"2005","unstructured":"Gabal-Shehab L, Alagiri M (2005) Traumatic adrenal injuries. J Urol 173:1330\u20131331","journal-title":"J Urol"},{"key":"6335_CR56","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1177\/1742271X20951915","volume":"29","author":"TS Aderotimi","year":"2021","unstructured":"Aderotimi TS, Kraft JK (2021) Ultrasound of the adrenal gland in children. Ultrasound 29:48\u201356","journal-title":"Ultrasound"},{"issue":"4","key":"6335_CR57","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1016\/j.jpedsurg.2003.12.010","volume":"39","author":"BA Gaines","year":"2004","unstructured":"Gaines BA, Schultz BS, Morrison K et al (2004) Duodenal injuries in children: beware of child abuse. J Pediatr Surg. 39(4):600\u2013602","journal-title":"J Pediatr Surg."},{"key":"6335_CR58","doi-asserted-by":"publisher","first-page":"100057","DOI":"10.1016\/j.yjpso.2023.100057","volume":"4","author":"LN Garzon","year":"2023","unstructured":"Garzon LN, Moreno MD, Hern\u00e1ndez MA et al (2023) Clinical importance in the early identification of non-accidental trauma in pediatric population: a comparative study among patients of a high \u2013 complexity reference hospital. J Pediatr Surg Open 4:100057","journal-title":"J Pediatr Surg Open"},{"key":"6335_CR59","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1097\/TA.0b013e3182788cb2","volume":"74","author":"L Sowrey","year":"2013","unstructured":"Sowrey L, Lawson KA, Garcia-Filion P et al (2013) duodenal injuries in the very young child: child abuse? J Trauma Acute Care Surg 74:136\u2013142","journal-title":"J Trauma Acute Care Surg"},{"key":"6335_CR60","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1016\/S0022-3468(97)90642-4","volume":"32","author":"J Shilyansky","year":"1997","unstructured":"Shilyansky J, Pearl RH, Sena LM et al (1997) Diagnosis and management of duodenal injuries in children. J Pediatr Surg 32:880\u2013886","journal-title":"J Pediatr Surg"},{"key":"6335_CR61","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1097\/01.TA.0000056184.80706.9B","volume":"54","author":"KM Desai","year":"2003","unstructured":"Desai KM, Dorward IG, Minkes RK et al (2003) Blunt duodenal injuries in children. J Trauma 54:640\u2013645","journal-title":"J Trauma"},{"key":"6335_CR62","doi-asserted-by":"publisher","first-page":"e2024070074","DOI":"10.1542\/peds.2024-070074","volume":"155","author":"S Haney","year":"2025","unstructured":"Haney S, Scherl S, DiMeglio L et al (2025) Evaluating young children with fractures for child abuse: clinical report. Pediatrics 155:e2024070074","journal-title":"Pediatrics"},{"key":"6335_CR63","doi-asserted-by":"crossref","unstructured":"Lindberg DM, Harper NS, Laskey AL, ExSTRA Investigators et al (2013) Prevalence of abusive fractures of the hands, feet, spine, or pelvis on skeletal survey: perhaps \u201cuncommon\u201d is more common than suggested. Pediatr Emerg Care 29:26\u201329","DOI":"10.1097\/PEC.0b013e31827b475e"},{"key":"6335_CR64","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1148\/radiology.182.3.1535886","volume":"182","author":"CJ Sivit","year":"1992","unstructured":"Sivit CJ, Taylor GA, Bulas DI et al (1992) Posttraumatic shock in children: CT findings associated with hemodynamic instability. Radiology 182:723\u2013726","journal-title":"Radiology"},{"key":"6335_CR65","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1097\/01.rct.0000166635.54240.0d","volume":"29","author":"OA Catalano","year":"2005","unstructured":"Catalano OA, Napolitano M, Vanzulli A (2005) Black kidney sign: a new computed tomographic finding associated with the hypoperfusion complex in children. J Comput Assist Tomogr 29:484\u2013486","journal-title":"J Comput Assist Tomogr"},{"key":"6335_CR66","doi-asserted-by":"publisher","first-page":"e1400","DOI":"10.1542\/peds.2010-2096","volume":"127","author":"WG Lane","year":"2011","unstructured":"Lane WG, Lotwin I, Dubowitz H et al (2011) Outcomes for children hospitalized with abusive versus noninflicted abdominal trauma. Pediatrics 127:e1400\u20131405","journal-title":"Pediatrics"}],"container-title":["Pediatric Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00247-025-06335-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00247-025-06335-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00247-025-06335-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:03:57Z","timestamp":1777615437000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00247-025-06335-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,2]]},"references-count":66,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["6335"],"URL":"https:\/\/doi.org\/10.1007\/s00247-025-06335-x","relation":{},"ISSN":["1432-1998"],"issn-type":[{"value":"1432-1998","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,2]]},"assertion":[{"value":"21 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr. Ruiz-Maldonado and Dr. Henry have provided testimony in cases with concern for child maltreatment for which their institutions received payment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}