@article{ref1,
title="Medical child abuse: an unusual "source" of vaginal bleeding",
journal="Journal of Pediatric and Adolescent Gynecology",
year="2019",
author="Kelley, David M. and Curran, Kelly A.",
volume="32",
number="3",
pages="334-336",
abstract="BACKGROUND: Medical child abuse (MCA) is challenging to diagnose. While young children are often affected, adolescents can be victims through caregiver coercion. Presentation is highly variable. Diagnosis is essential due to high associated morbidity and mortality. CASE: We describe the case of a 12 year-old girl who presented to multiple subspecialty clinics with reported menorrhagia. Despite reassuring clinical examinations, the family described menorrhagia that failed to respond to standard treatment. After an urgent evaluation for reported heavy bleeding revealed only scant blood, the diagnosis of MCA was made. SUMMARY AND CONCLUSION: Vaginal bleeding is a rare presentation of MCA, but must be considered whenever reported symptomatology does not follow physiologic patterns, respond to standard medical treatment or correspond to clinical evaluation. Prompt identification is important to prevent further harm.<br><br>Copyright © 2019. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="1083-3188",
doi="10.1016/j.jpag.2019.03.003",
url="http://dx.doi.org/10.1016/j.jpag.2019.03.003"
}