Laceration of the liver with delayed massive intra-abdominal hemorrhage: a case report of child abuse.

A 3-year-old girl was found unresponsive in the bedroom and expired at a hospital. Autopsy revealed massive intra-abdominal bleeding due to laceration of the liver and mesenterium with multiple rib fractures and multiple fresh and old bruises. The time of the assault causing the liver trauma was questioned because the perpetrator, her mother's boyfriend, denied any outrages on that particular day although he confessed that he had physically abused her for several months. Microscopically, numerous polymorph leucocytes infiltrated exclusively surrounding the lacerated area of the liver. Many hepatocytes were necrotic and cord arrangement of the parenchymal cells was destroyed. There should be a certain time lag between the major assault and massive intra-abdominal hemorrhage, which was not inconsistent with the statement of the perpetrator.