2110. Imaging Patterns of Abdominal Injuries in Survivors of Intimate Partner Violence (IPV)
Authors* Denotes Presenting Author
Jonathan McDougal *;
Brigham and Women's Hospital
Ellen Sun;
Brigham and Women's Hospital
Felipe Franco;
Brigham and Women's Hospital
Bharti Khurana;
Brigham and Women's Hospital
Objective:
To describe the pattern and distribution of abdominal injuries in survivors of intimate partner violence (IPV).
Materials and Methods:
A work in progress retrospective radiologic review 288 patients (less than 40% of cohort to be analyzed) reporting physical IPV to our institution’s violence prevention program over five years has so far identified 13 patients with 18 abdominal injuries related to IPV. Imaging and demographic data were collected.
Results:
Abdominal data has been partially reviewed. Current aggregate abdominal data includes 9 women and 4 men with a median age of 40 years (19-70 years). Eight patients (62%) reported IPV at the time of injury. Seven of these 8 patients had sustained penetrating trauma. Among 5 patients who did not disclose IPV at presentation, only 1 was screened for IPV after injury characterization. Four out of 5 patients reported a traumatic fall as the mechanism of injury at presentation, then later disclosed IPV. Abdominal wall laceration was the most common injury seen in 44.4% (8/18), followed by visceral organ injury (4/18), abdominal contusions (3/18), fractures (2/18), and retroperitoneal hematoma (1/18). Abdominal wall lacerations were more common in upper abdomen than lower (85.7% versus 15.3%, respectively), while all contusions were seen in the pelvis. Among visceral injuries, splenic injuries comprised 50% of the lesions, followed by liver laceration (25%) and colonic perforation (25%). The most frequent concomitant injuries involved the upper extremity in 5/13 (38%) patients. Metachronous injury is common, with five patients (38%) demonstrating a total of 15 injuries on radiologic studies prior to the indexed abdominal injury, the most common being cranial injuries (5/15; 33%).
Conclusion:
IPV continues to be under-reported and under-diagnosed. Although IPV may be more frequently disclosed with penetrating trauma, patients with blunt trauma often report fall as the cause of their injury. For patients with an unclear mechanism of injury, the presence of abdominal wall injury (contusions or laceration) with a history of, or concomitant indicative injuries of, the head, neck, face, chest, and/or extremities should prompt the radiologist to discuss the possibility of IPV with the ordering physician. Through this work we want to create awareness of IPV-related imaging findings in the abdomen among radiologists and reinforce their potential role in early identification.
