How to judge the damage of internal organs in babies

Babies are very delicate after birth, and many new parents dare not touch them for fear of accidentally hurting them. Some new parents are very careful and cautious when taking care of their babies, while others do not trust themselves and ask experienced caregivers to take care of their babies. Nowadays, we often see news about caregivers abusing babies. So how do parents judge whether the baby's internal organs are damaged?

Symptoms of visceral injury include pain that worsens with movement and coughing, and are often accompanied by intermittent colic, obvious tenderness, and weakened breathing. Abdominal breathing weakens when the abdomen is bruised; chest breathing weakens when the chest is bruised; kidney injury often causes hematuria; gastric and intestinal bleeding may cause black stools or bright red stools (stools from gastric bleeding are generally black, and stools from large intestinal bleeding are bright red).

2. Pathological Causes

1. Direct blow, the abdomen or feet are directly hit by external force;

2. Squeezing, such as when turning over, the liver, spleen, kidneys, stomach, intestines, etc. may be injured due to squeezing;

3. The body suddenly stops moving or twists, which is usually seen in falls from a height or car accidents, and mainly damages the liver, spleen, and kidneys.

Examination items: Color Doppler ultrasound, CT, blood gas analysis, photos, blood pressure

For open injuries, it is usually not difficult to diagnose liver damage based on the location, depth and direction of the wound. The diagnosis of closed true liver laceration with obvious intra-abdominal bleeding and peritoneal irritation signs is not difficult. However, for subcapsular liver laceration, subcapsular hematoma and central laceration, it may be difficult to diagnose liver laceration when the symptoms and signs are not obvious. A comprehensive analysis must be made based on the injury and clinical manifestations, and changes in vital signs and abdominal signs must be closely observed. The following tests may help with diagnosis:

(I) Diagnostic abdominal puncture

This method is of great value in diagnosing rupture of intra-abdominal organs, especially laceration of solid organs. Generally, if the blood does not coagulate, it can be considered that there is internal organ damage. However, a false-negative result may occur when the amount of bleeding is small, so a negative puncture result cannot rule out visceral injury. If necessary, multiple punctures can be performed at different locations and times, or diagnostic peritoneal lavage can be performed to assist in diagnosis.

(ii) Regularly measure red blood cells, hemoglobin and hematocrit to observe their dynamic changes. If there are signs of progressive anemia, it indicates internal bleeding.

(III) Type B ultrasound examination: This method can not only detect intraperitoneal blood accumulation, but also helps in the diagnosis of subcapsular hematoma and intrahepatic hematoma. It is commonly used in clinical practice.

(iv) X-ray examination may reveal subcapsular hematoma or hollow organ damage.

For closed injuries with unclear diagnosis, suspected subcapsular or intrahepatic hematoma, and non-urgent conditions, an isotope liver scan may be performed if the patient's condition permits. Patients with hematoma will show radioactive defect areas in the liver.

6. Selective hepatic artery angiography

This method can be used for some closed injuries that are difficult to diagnose, such as suspected intrahepatic hematoma, and the injury is not very urgent. Diagnostic signs such as aneurysm formation of intrahepatic artery branches or contrast agent extravasation may be seen. However, this is an invasive examination with complicated operation. It can only be performed under certain conditions and cannot be used as a routine examination.