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Images in paediatrics
‘Oral injury in child abuse’
  1. Frances Zelda Howsam1,
  2. Leonie Perera2,
  3. John Trounce2
  1. 1 Department of Paediatric Intensive Care, Kings College Hospital, Brighton, UK
  2. 2 Department of Paediatrics, Brighton and Sussex University Hospital, Brighton, UK
  1. Correspondence to Dr Frances Zelda Howsam, Kings College Hospital, Kings College Hospital, Denmark Hill, London SE5 9RS, UK; fhowsam{at}

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An 11-month-old female infant attended accident and emergency with haematemesis. There was no preceding gastroenteritis, liver stigmata or trauma. Examination revealed bilateral, two centimetre supratonsillar lacerations and scattered petechiae over the forehead and nasal bridge.

The ear-nose-throat ENT team found white slough tissue indicating wound healing. Concerns were raised regarding delay in presentation, minimal explanation and previous partner's domestic …

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  • Contributors FZH: investigation, drafting and critical revision. LP: concept, drafting, critical revision and final approval. JT: concept and critical revision.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.