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Editor,—Carers of children need to be aware of the wide range of possible non-accidental injuries so that they may be recognised and managed appropriately. The insertion of sharp needles into body cavities or soft tissues is an uncommon form of child abuse and we wish to report three cases presenting to us during a four year period.
Case 1—A 4 week old infant of Asian parents died before being admitted to the emergency department. A necropsy confirmed the cause of death as bacterial pneumonia. Examination of the scalp revealed a healed 1 cm laceration posterior to the anterior fon-tanelle. Tracts led to three broken sewing needles embedded within the occipital lobes.
Case 2—A female sibling to case 1 had previously presented at the emergency department with bruises, abrasions, and burns. A skeletal survey demonstrated four needles in the soft tissues of the head, neck, and forearm. These were removed surgically and found to be sewing needles.
Case 3—A baby boy was born at 25 weeks’ gestation after a concealed pregnancy in a young African mother. An abdominal radiograph at 3 weeks demonstrated two linear opaque objects in the abdomen. Repeat radiography after 10 days showed two further similar objects in the pelvis. At laparotomy four needles were removed.
The insertion of sharp needles through the skin or mucus membranes of young children is a rare form of non-accidental injury with only seven other cases having been reported.1-4 We are not aware that this is a recognised part of African or Indian culture and this must be considered and managed as child abuse.
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