Mesenteric fibrosis—a histologic marker of previous blunt abdominal trauma in early childhood

Abstract

A girl aged 21 months and a boy aged 3 years both died of hemorrhage from intestinal and mesenteric lacerations due to inflicted blunt abdominal trauma. Histologic examination of sections from the areas of duodenal and mesenteric lacerations confirmed changes of acute injury with hemorrhage, acute inflammatory infiltrates, and surface fibrin deposition. In addition, in both cases, there was also evidence of much longer-standing trauma with mesenteric fibrosis and hemosiderin-containing macrophages (the latter in keeping with previous hemorrhage). In the absence of a history of surgery and local inflammatory disease, these findings suggest that these children had suffered previous abdominal trauma, possibly from similar types of injuries. Scarring of the mesentery and intestine in cases of lethal childhood blunt abdominal trauma may provide evidence of previous similar, significant although sublethal tissue damage. Extensive histologic sampling of abdominal organs and tissues including the mesentery can, therefore, be extremely useful in such cases.