Citation

Hauet-Wiedemann M, Wiedemann A, Gatin A, Renaud E, Lapp L, Franchi A, Martrille L, Borsa-Dorion A. Arch. Pediatr. 2018; 25(4): 247-250.

Vernacular Title

Agressions sexuelles sur mineurs : étude d’une population d’enfants ayant consulté dans une unité médico-judiciaire hospitalière entre 2011 et 2015.

Affiliation

Service des urgences pédiatriques, centre hospitalier régional universitaire de Nancy, rue du Morvan, 54000 Nancy, France.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.arcped.2018.03.004

PMID

29656040

Abstract

BACKGROUND: When child sexual abuse (CSA) is suspected, the detection of anogenital anomalies is rare. In France, since 2011, most clinical examinations of children for whom CSA is suspected take place in the forensic medical service (FMS).

OBJECTIVES: To describe a population of children examined for suspected CSA in the FMS of the Nancy Regional University Hospital Center.

PATIENTS AND METHODS: Children under the age of 18 who consulted for suspected CSA in the Nancy FMS between 2011 and 2015 were included. Demographic data as well as data from questioning, the physical examination, any further examination, and the medical conclusions were collected.

RESULTS: Three hundred and twenty-five girls and 79 boys were enrolled. The average age at the time the abuse was committed was 118.9 months. Two hundred sixty-nine (66.6%) children alleged fondling and 59 (14.6%) fellatio. Two hundred twelve victims (52.5%) described a penetration, 163 (76.9%) in the vagina and 73 (34.4%) in the anus. Significant bruises were found at the examination of 13 children, accounting for 2.5% of all victims. Thirty-four (11.7%) girls had lesions in the external genitalia and 28 (9.8%) lesions of the virginal membrane. One boy (1.3%) had a nonspecific lesion of the external genitalia. Six (8.2%) children alleging anal penetrations showed injury. The examiner concluded that clinical examinations were compatible with alleged facts for 253 (62.6%) victims. It was impossible to conclude for 116 (28.7%) children.

CONCLUSION: In the case of suspected CSA, the clinical examination is frequently normal. This examination must be performed by physicians trained in child abuse, under appropriate conditions. It is important not to jump to conclusions about the reality of the alleged facts. A multidisciplinary approach, with the cooperation of the medical, social, and forensics sector is necessary.

Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Language: fr

Keywords

Child sexual abuse; Forensic medical service