child maltreatment should be suspected if a child has an intra-abdominal or intrathoracic injury in the absence of major confirmed accidental trauma and there is an absent or unsuitable explanation , or a delay in presentation. There may be no external bruising or other injury
Notes:
for the purposes of this guideline, NICE state that to suspect child maltreatment means a serious level of concern about the possibility of child maltreatment but is not proof of it
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