Sinani Fatos, Ymaj Besim, Vyshka Gentian
Pathology Department, Institute of Forensic Medicine, Tirana, Albania.
BMJ Case Rep. 2011 Oct 16;2011:bcr0720114545. doi: 10.1136/bcr.07.2011.4545.
The case of an 18-month child is presented, with a picture demonstrating the thoracic trauma, caused from a hand pressure movement, perpetrated with an open right palm, in an attempt to perform an external cardiac massage. The child showed continuous episodes of 'crying spells' that the medical staff considered as benign, but an overprotective and mentally unstable mother kept on violently 'resuscitating' her son during such episodes. The last episode was characterised with a strenuous massage of the thoracic wall, causing evident bruises and leading to a cardiac contusion. The mother who perpetrated the trauma was sentenced for manslaughter, after the accidental character of the event, as well as the severity of her family situation and the precarious living environment of a socially abandoned single-acting parent, were all taken into account. The particular psychopathology of the care giver (mother) and the characteristics of the inflicted thoracic blow are described.
本文介绍了一名18个月大儿童的病例,配有一张图片展示了胸部创伤,该创伤是在试图进行体外心脏按摩时,用张开的右手掌进行手部按压动作所致。该儿童出现持续的“哭闹发作”,医护人员认为这些发作是良性的,但一位过度保护且精神不稳定的母亲在这些发作期间不断暴力地“抢救”她的儿子。最后一次发作的特点是对胸壁进行剧烈按摩,导致明显瘀伤并引发心脏挫伤。造成创伤的母亲因过失杀人罪被判刑,原因是考虑到该事件的意外性质、她的家庭状况的严重性以及作为社会弃儿的单亲家长不稳定的生活环境。文中描述了照顾者(母亲)的特殊精神病理学以及所施加的胸部打击的特征。