Nadjem H, Sutor A H
Institut für Rechtsmedizin, Universität Freiburg/Br.
Beitr Gerichtl Med. 1991;49:227-31.
A 4-year-old child, suspected of being the victim of child abuse was sent for forensic examination. The examination established multiple, uncharacteristically shaped haematomata in various parts of the body. In addition, petechiae were also present. In view of the nature and localisation of the haematomata and the presence of petechial bleeding a differential diagnosis considered the possibility of a haematological disease and clinical paediatric tests were done to establish the cause, which showed an acute lymphatic leukaemia (ALL) with thrombo(cyto)penia. As haematomata are often the first indication of a leucosis, whenever child abuse is suspected, this possibility should also be considered.
一名疑似遭受虐待的4岁儿童被送去进行法医检查。检查发现身体各部位有多处形状异常的血肿。此外,还存在瘀点。鉴于血肿的性质和位置以及瘀点出血的情况,鉴别诊断考虑了血液系统疾病的可能性,并进行了临床儿科检查以确定病因,结果显示为急性淋巴细胞白血病(ALL)伴血小板减少症。由于血肿往往是白血病的首个迹象,所以每当怀疑有儿童虐待时,也应考虑这种可能性。