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5 years ago
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1 Introduction 373

2 374

3 Definition of Child Abuse 375

4 376

5 Current Status of Child Abuse 377

6 378

7 Causes of Child Abuse 379

8 Signs and Sequelae of Child Abuse 380

9 A B C 381

10 382

11 383

12 384

13 385

14 Clinical Evaluation of Abused Child 386

15 1. : (ITP), 2. : (purpura), (vasculitis) 3. : K, 4. : 5. : 5. : (Osteogenesis imperfect ) 6. : (clumsiness),, 6. : X ( ) :, Menkes, 3. : Mucolipidosis 4. :, Methotrexate Prostaglandin 5. :, 6. :, Osteogenesis imperfecta, Caffey 7. :, Metastatic neuroblastoma, Histiocytosis X 8. : Toddler s fracture 11. : CBC, Bleeding/Clotting studies 12. X : ( ), 12. X : 13. X : Brain CT scan * 14. : Drug & toxic screening tests * 15. : ** 16. ** 17. ** ,, ** 10. *. **. 387

16 Special Issue 1. (,, ) :,, HSV, CMV B ( )

17 389

18 Special Issue S30 Superficial injury of abdomen, lower back and pelvis S30.2 contrusio of external genital organs ( ) : labium( ), perineum( ), vagina( ), vulva( ) S31 Open wound of abdomen, lower back and pelvis S31.4 open wound of abdomen and vulva ( ) S31.5 open wound of other and unspecified external organs ( ) S37 Injury of pelvic organs S37.3 injury of urethra () S37.4 injury of ovary () S37.5 injury of fallopian tube () S37.6 injury of uterus () S37.7 injury of multiple pelvic organs ( ) S37.8 injury of other pelvic organs ( ) : adrenal gland( ) S37.9 injury of unspecified pelvic organs ( ) S38 Crushing injury and traumatic amputation of part of abdomen, lower back and pelvis S38.0 crushing injury of external genital organs ( ) S38.1 crushing injury of other and unspecified parts of abdomen, lower back and pelvis (, ) S38.2 traumatic amputation of external genital organs ( ) : labium( ), vulva( ) T74 Maltreatment syndrome T74.2 sexual abuse ( ) Y05 Sexual assault by bodily force rape (attempted) ; Z04.4 Examination and observation following alleged rape and seduction ( ) Examination of victim or culprit following alleged rape or seduction ( ) 390

19 T74 Maltreatment syndrome T74.0 neglect or abandonment ( ) T74.1 physical abuse ( ) T74.2 sexual abuse ( ) T74.3 psychological abuse ( ) T74.8 other maltreatment syndrome ( ) Z60 Problems related to social environment Z60.4 social exclusion and rejection ( ; ) Z61 Problems related to negative life events in childhood Z61.4 problems related to alleged sexual abuse of child within primary support group ( ) Z61.5 problems related to alleged sexual abuse of child outside primary support group ( ) Z61.6 problems related to alleged physical abuse of child ( ) Z61.7 personal frightening experience in childhood ( ; ) Z62 Other problems related to up bring Z62.1 inadequate parental supervision and control ( ) Z62.2 parental overprotection ( ) Z62.3 institutional upbringing ( ) Z62.3 hostility towards and scapegoating of child ( ) Z62.4 emotional neglect of child ( ) Z62.5 other problems related to neglect in upbringing ( ) Z62.6 inappropriate parental pressure and other abnormal quality of upbringing ( ) Z62.8 other specified problem related to upbringing ( ) Z63 Other problems related to primary support group, including family circumstances Z00 General examination and investigation of without complaint or reported diagnosis Z00.0 general medical examination Z00.4 general psychiatric examination Z02 Examination and encounter for administrative purposes Z02.7 issue of medical certificate Z13 Special screening examination for other diseases and disorders Z13.3 special screening examination for mental and behavioral disorders Z13.4 special screening examination for certain developmental disorders in childhood 391

20 Special Issue 392

21 Confirmation of Child Abuse 393

22 394

23 395

24 396

25 Obligation to Report Child Abuse 397

26 398

27 399

28 Emergent Care of Abused Child 400

29 401

30 Child Protection Service 402

31 403

32 Prevention and Treatment of Child Abuse 404

33 405

34 406

06.....

06..... Special Issue VOL. 39 NO. 4 2006. 4 29 Special Issue 30 VOL. 39 NO. 4 2006. 4 31 Special Issue 32 VOL. 39 NO. 4 2006. 4 33 Special Issue 34 VOL. 39 NO. 4 2006. 4 35 Special Issue 36 VOL. 39 NO. 4 2006.