Small Bowel Evisceration: Unusual Manifestation of Child Abuse

More than 2.4 million cases of child abuse were reported in the 48 states and the District of Columbia in 1989.1 Of these, 55% were classified as neglect, 30% as physical abuse, 16% as sexual abuse, and 8% as emotional maltreatment.1 These percentages include cases in which more than one type of abuse was reported. Common manifestations of child abuse include bruises; burns; and central nervous system, intra-abdominal (blunt as well as penetrating), and genital injuries. Unusual manifestations of child abuse have included sudden infant death syndrome, apnea, poisonings, and bizarre illnesses stemming from Munchausen syndrome by proxy. In recent years, there has been a marked increase in the number of reported cases of child abuse, especially sexual abuse.