Kirschner R H, Stein R J
Am J Dis Child. 1985 Sep;139(9):873-5. doi: 10.1001/archpedi.1985.02140110027022.
The suspected diagnosis of child abuse may prove to be unfounded. Reports in the literature have focused on unusual diseases and folk medicine practices that may mimic abuse. We report ten cases where allegations of abuse were lodged against parents because the treating physicians in the emergency room mistook life-threatening illness or postmortem artifacts for inflicted injury. In all cases the families were from the inner city, and with two exceptions the involved institutions were small hospitals without pediatric personnel present in the emergency department. Although the histories related by the parents were in all cases truthful and consistent with the results of physical examinations of the child, the involved physicians failed to make a correct diagnosis. Not only a lack of experience with severe childhood illness and death but also an attitude of suspicion and/or hostility probably contributed to these misdiagnoses.
虐待儿童的疑似诊断可能最终被证明毫无根据。文献报道主要集中在可能被误诊为虐待的罕见疾病和民间医疗行为上。我们报告了10起针对父母的虐待指控案例，原因是急诊室的主治医生将危及生命的疾病或死后尸检痕迹误判为受虐伤。所有案例中的家庭均来自市中心，除两起案例外，涉事机构均为小型医院，急诊科没有儿科医护人员。尽管所有案例中父母讲述的病史都是真实的，且与孩子的体格检查结果相符，但涉事医生仍未能做出正确诊断。这些误诊可能不仅是因为缺乏对儿童重症疾病和死亡情况的经验，还因为怀疑和/或敌对态度。
