TY  - JOUR
PY  - 2020//
TI  - Non-obstetric vulvar/paravaginal hematoma in an adolescent girl with scleroderma: an opportunity for intimate partner violence intervention
JO  - HCA healthcare journal of medicine
A1  - Burnham, Amanda
A1  - Cooke-Barber, Jo
A1  - Thacker, Stephen
A1  - Evans, Donna
A1  - Carney, David
A1  - Boswell, William
SP  - 211
EP  - 215
VL  - 1
IS  - 4
N2  - Description A 15-year-old female presented to the emergency department with swelling and pain in her left labial region as well as urinary retention after intercourse. This was the patient's first time having sexual intercourse and the patient stated that her boyfriend "kneed" her in the labia. A CT scan of the pelvis revealed a large vulvar/external hematoma measuring 6 × 10 × 7 cm which extended into the vaginal vault. This case is the first of a vulvar hematoma reported in a pediatric patient with scleroderma. This case was complicated by the fact that our patient claimed her boyfriend intentionally "kneed" her in the labia, thereby calling sexual abuse into question. Discerning between childhood connective tissue disorders and abuse injuries can be difficult, especially in genital trauma. The treatment team suspected early on that this was a case of intimate partner assault based on the severity of the injury alone and continued when she presented again to the emergency department with concerns for abuse. Sexual violence should be high on the differential in children with connective tissue disorders who present with vulvar or paravaginal hematomas. In our opinion, these injuries warrant a thorough investigation by a child abuse specialist, child protective services and law enforcement.<p />  <p>Language: en</p>
LA  - en
SN  - 2689-0216
UR  - http://dx.doi.org/10.36518/2689-0216.1043
ID  - ref1
ER  -