Figure 3a. Confirmed child abuse in an 18-month-old girl with an initial history of "falling down steps." CT scans show a markedly irregular distal duodenum (black arrowheads) and marked diffuse mesenteric stranding (M in b) and free fluid (F). Small bubbles of free intraperitoneal air are present anteriorly (white arrowheads). The proximal jejunum is dilated (J in b). At surgery, a transection was found at the duodenal-jejunal junction.