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Abstract
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Three two-year datasets of ano-genital signs were collected for comparisons of the injuries seen with accidental trauma and child sexual abuse in children less than 16 years of age: (1) Those attending a regional children's emergency department (South East Scotland) (n = 146) for injuries to the ano-genital area; (2) all admissions to hospital in Scotland for straddle injury (n = 56); and (3) all children attending a regional child abuse and neglect service for assessment of suspected child sexual abuse (n = 98). Accidental injury types were combined for comparison with abusive injuries.
'Three two-year datasets of ano-genital signs were collected for comparisons of the injuries seen with accidental trauma and child sexual abuse'
In South East Scotland, 1:1785 children under 16 years will attend an emergency department and 1:9305 will be admitted annually for an ano-genital injury.
In boys, penile and scrotal injuries were only seen following accidents; anal injury was more frequent following suspected abuse (36%) than after accidents (5%).
In girls, injuries to the perineum and labia were more frequent after accidental trauma (32% and 74%, respectively, compared to 2% and 11% following suspected abuse), while hymenal injuries were more frequent after sexual abuse (19% compared to 1% in the accident group). Acute injuries to the posterior fourchette were common from both causes, (17% accidents and 10% abuse) and vaginal injuries were uncommon in both groups (5% accidents and 2% abuse).
The sites of injury may assist in the differential diagnosis of the cause in ano-genital injuries. Copyright © 2017 John Wiley & Sons, Ltd
Key Practitioner Messages
* Hymenal or vaginal injury is very unlikely in accidental ano-genital injury unless there are indications of significant impalement.
* Perineal and labial injuries are very common in accidental ano-genital injury.
* Injuries to the posterior fourchette poorly differentiate abusive and accidental ano-genital injuries.
* In boys, penile and scrotal injuries are more common following accidental injury, whereas anal/perianal injuries are more likely abusive.
Language: en |