Esophageal perforation preceding fatal closed head injury in a child abuse case.

This is a case describing an extensive esophageal perforation in a 15-day-old infant with an unclear mechanism of injury, who at 3 months of age presented as the victim of child abuse from a fatal closed head injury. Extensive esophageal perforation in a neonate or infant is usually induced by trauma, either accidental or non-accidental. When the given history does not correlate with the degree of injury, child abuse must be strongly suspected and a thorough social investigation must be undertaken.