A mother presented to the emergency department with her 3-year-old child asking about an upper respiratory infection (URI) and an incidental wound around the child’s neck. The mother reported that her 3 children had been visiting their father and the child in question had been choked by a dog leash during the visit. The mother denied any knowledge of how the accident had occurred. This injury had reportedly occurred several hours earlier, and the mother also denied being aware of any physician contact after the injury. The mother had little regard for the injury but was concerned about the URI.
Except for the neck injury and the URI symptoms, the physical examination was unremarkable. No addition tests were done at this point.
Because of the delay in seeking care and the appearance of a possible choking injury, the ED staff wanted more information about the injury before discharging the child. The father was contacted and gave an almost unbelievable account of the accident. The child was alleged to have been walking the neighbor’s dog when he became tangled in the leash. The explanation was inconceivable as first described by the father. Social service was contacted for more input into the etiology of the injury.
Has this child been abused, or is this a child abuse mimic?
Answer and discussion on next page.