Subdural Hemorrhage Related to Vitamin K Deficiency in an Infant with Choledochal Cyst
The deceased was a 6-month-old male infant who was transferred to the hospital due to jaundice and vomiting. During admission, subdural hemorrhage and retinal hemorrhage were observed; additionally, a rib fracture was identified on the previous radiography images, which had eventually healed by the...
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Published in | Korean Journal of Legal Medicine Vol. 44; no. 4; pp. 163 - 168 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
대한법의학회
30.11.2020
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Online Access | Get full text |
ISSN | 2383-5702 1225-0589 2383-5710 2287-2078 2383-5710 |
DOI | 10.7580/kjlm.2020.44.4.163 |
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Abstract | The deceased was a 6-month-old male infant who was transferred to the hospital due to jaundice and vomiting. During admission, subdural hemorrhage and retinal hemorrhage were observed; additionally, a rib fracture was identified on the previous radiography images, which had eventually healed by the time of the follow-up study. This case was reported to the police, alleging child abuse, which led to a medicolegal dispute between the hospital and the deceased's parents. In addition, bleeding tendency and coagulopathy related to vitamin K deficiency were also found. The past history revealed that the deceased had diarrhea, jaundice, and experienced several episodes of acholic stools, and low levels of vitamin D at birth. On postmortem examination, the brain already revealed liquefactive necrosis, but subdural hemorrhage was still observed. The optic nerves of both eyes revealed hemorrhage with focal retinal hemorrhage.
No definite fracture was identified; however, osteopenia was observed in the long bones. The liver showed septal fibrosis and cholestasis which is nearly biliary cirrhosis, and mild dilation of the intrahepatic and extrahepatic bile ducts, suggesting a choledochal cyst. This case illustrates that subdural hemorrhage related to vitamin K deficiency could occur in an infant with a choledochal cyst.
When subdural hemorrhage is encountered in a child with what is considered an intentional head injury, the possibility of spontaneous hemorrhage should be excluded. KCI Citation Count: 0 |
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AbstractList | The deceased was a 6-month-old male infant who was transferred to the hospital due to jaundice and vomiting. During admission, subdural hemorrhage and retinal hemorrhage were observed; additionally, a rib fracture was identified on the previous radiography images, which had eventually healed by the time of the follow-up study. This case was reported to the police, alleging child abuse, which led to a medicolegal dispute between the hospital and the deceased's parents. In addition, bleeding tendency and coagulopathy related to vitamin K deficiency were also found. The past history revealed that the deceased had diarrhea, jaundice, and experienced several episodes of acholic stools, and low levels of vitamin D at birth. On postmortem examination, the brain already revealed liquefactive necrosis, but subdural hemorrhage was still observed. The optic nerves of both eyes revealed hemorrhage with focal retinal hemorrhage.
No definite fracture was identified; however, osteopenia was observed in the long bones. The liver showed septal fibrosis and cholestasis which is nearly biliary cirrhosis, and mild dilation of the intrahepatic and extrahepatic bile ducts, suggesting a choledochal cyst. This case illustrates that subdural hemorrhage related to vitamin K deficiency could occur in an infant with a choledochal cyst.
When subdural hemorrhage is encountered in a child with what is considered an intentional head injury, the possibility of spontaneous hemorrhage should be excluded. KCI Citation Count: 0 |
Author | Choi, Byung-Ha Cha, Jang Gyu Park, Sohyung |
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Cites_doi | 10.1007/s00383-017-4083-6 10.1016/j.forsciint.2009.02.005 10.1097/MD.0000000000006679 10.3171/2011.12.PEDS11279 10.3748/wjg.v20.i30.10606 10.4103/1817-1745.66681 10.1136/adc.49.8.641 10.1007/s003830050033 10.1136/adc.86.2.98 |
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Title | Subdural Hemorrhage Related to Vitamin K Deficiency in an Infant with Choledochal Cyst |
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