An infant with minor blunt trauma with shock.

ABSTRACT

An infant who had a history of minor blunt trauma and later developed shock was reported. He was initially presented at the hospital because his mother noticed an abrasion on his nose that wouldn't stop bleeding for more than ten hours. The day before, his 3-year-old brother, imitating a wrestler, hit him in his abdomen and accidentally scratched his face, which brought him to the trauma emergency department the following and accidentally scratched his face, which brought him to the trauma emergency department the following day. The baby appeared active at first but looked pale; within 2 hours he became hypotensive and drowsy. His blood test had a prolonged bleeding time with very low fibrinogen and his blood concentration dropped 5%. The computed topographic scan located a chronic and subacute subdural hematoma without intraabdominal abnormalities. There had been previous reports of isolated head injuries which caused hypotension but our patient had a coincident coagulopathy also. The management and etiology of the patient were discussed. We concluded that in a traumaized child with shock major systems should be evaluated together because an isolated head injury can cuase hypotension and to emphasize the abdomen as the leading cause would only delay the management.