Subcutaneous emphysema of the neck in infancy: under-recognized presentation of child abuse

Abstract

Two cases of subcutaneous emphysema of the neck as a result of abuse in infancy are presented to add to the variety of findings associated with the maltreatment of infants. Pharyngeal perforations as a result of abuse are rare. These cases are presented as a reminder to the attending clinician that although most cases of subcutaneous emphysema may resolve without any complications a detailed examination for the cause should be performed and the history carefully verified.

Child abuse and fabricated or induced illness in the ENT setting: a systematic review

“…Included studies were separated into those pertaining to physical abuse (24 studies), and those relevant to FII (14 studies) . Within the physical abuse category, the studies were grouped into injuries to the throat (16 studies), ear (eight studies), and miscellaneous injuries (one study) …”

Paediatric hypopharyngeal perforation: Child abuse until proved otherwise?

“…The other cases involved an 18-month-old boy and a 2-year-old girl who fell over whilst brushing their teeth [12,13]. The remaining 19 cases were all either proven or highly suspicious of non-accidental injury [10,[14][15][16][18][19][20][21][22]31,[34][35][36].…”

“…Older children may complain of cervical pain. The diagnosis is often missed in the initial presentation [13][14][15]. Subcutaneous (''surgical'') emphysema if present is a very reliable sign of a perforation in the cervical oesophagus.…”

“…Subcutaneous (''surgical'') emphysema if present is a very reliable sign of a perforation in the cervical oesophagus. However, the crepitus is commonly missed in the initial examination [9,14,16]. Morbidity and mortality are directly related to delays in diagnosis and treatment [7].…”

Ear, Nose, and Throat Injuries in Abused Children

“…34 Evidence of enlargement of the retropharyngeal space, retropharyngeal air, or pneumomediastinum is sometimes found on imaging studies. A comprehensive examination should include sema.…”