@article{ref1,
title="A comparison of accidental and abusive ano-genital injury in children",
journal="Child abuse review",
year="2017",
author="McIntosh, Neil and Mok, Jacqueline Y. Q.",
volume="26",
number="3",
pages="230-244",
abstract="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.<p /> <p>Language: en</p>",
language="en",
issn="0952-9136",
doi="10.1002/car.2452",
url="http://dx.doi.org/10.1002/car.2452"
}