Vester M E M, Bilo R A C, Nijs H G T, van Rijn R R
Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands; Amsterdam Center for Forensic Science and Medicine, The Netherlands.
Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands.
Forensic Sci Int. 2018 Apr;285:e17-e20. doi: 10.1016/j.forsciint.2018.01.003. Epub 2018 Jan 10.
We present two cases of infants who died under suspicious circumstances. After clinical and legal investigations, non-accidental constrictive asphyxia inflicted by one of the parents was established. The first case presents a to date not yet reported, unique mechanism of trauma. In order to stop his daughter from crying, the father admitted that he sometimes sat on his baby while she was lying on the bed. Occasionally increasing his force by pulling with his hands on the bottom of the bed. In the second case tight swaddling and encircling chest compression was the causative mechanism. In both cases the father was sentenced to imprisonment with mandate psychiatric care. Only two previous reports of this uncommon and relatively unknown cause of child abuse, called constrictive asphyxia, are known. In all reported cases static loading of the chest resulted in rib fractures and demise of the child. This rare abusive mechanism should be known to pediatric radiologists and pathologists.
我们报告两例在可疑情况下死亡的婴儿病例。经过临床和法律调查，确定为父母一方实施的非意外性压迫性窒息。第一例呈现了一种迄今为止尚未报道过的独特创伤机制。为了让女儿停止哭闹，父亲承认有时会在女儿躺在床上时坐在她身上，偶尔还会用手拉住床尾来加大力度。在第二例中，紧紧包裹并环绕胸部按压是致病机制。在这两起案件中，父亲均被判处监禁并被责令接受精神治疗。此前仅有两份关于这种不常见且相对不为人知的虐待儿童原因（称为压迫性窒息）的报告。在所有报告的病例中，胸部的静态负荷导致肋骨骨折和儿童死亡。儿科放射科医生和病理学家应该了解这种罕见的虐待机制。
