Child abuse can mimic unusual manifestation as acute abdominal pain

Children can be easy victims of physical and sexual violence because they are extremely vulnerable and incapable of defending themselves.The consequences of child abuse and negligence are really serious and they may affect over the victims themselves and the society in which they live. Child abuse is manifested with different morphological traumatic injuries in different area of the victims. Most sexually abused children do not have any signs of genital or anal injury, especially when they are examined non-acutely.Case presentation:Case 1: 3.5 year old male with abdominal blunt trauma followed child abuse. He was stable and had pain and tenderness in upper segments of abdomen. US and CT scan revealed free fluid in abdomen and transection of the pancreas. He underwent conservative management. Follow up CT scan showed pseudo cyst. He is under expectant management. Reports from major pediatric trauma centers are clearly in conflict. Some favor and document the efficacy and safety of observational care for virtually all pancreatic injuries, including duct disruption;others advocate aggressive surgical management with debridement or resection.Case 2:10 year old male with abdominal pain from 2 days ago with abdominal tenderness in lower quadrant of abdomen. With suspicion to appendicitis underwent surgical exploration. Floating pencil in abdomen revealed. Pathology was sigmoid perforation followed clyster pencil by older friend in school. Conclusion: Physicians and health professionals should identify the signs of abuse and take legal action whenthere is strong suspicion or confirmation.