Signs of Genital Trauma in Female Child Sexual Abuse
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Date
2010-03-05
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Thammasat University, Rangsit Campus
Abstract
Background: Child sexual abuse is a common problem, but reports of the genital findings have not been published in Thailand. Objective: This study was designed to document the frequency and characteristics of genital injuries in female children and adolescents who had a history of sexual abuse by penile-vaginal penetration, and to determine any historical correlation of injuries. Subjects and Methods: Medical records of all female patients age 0-18 years evaluated for sexual abuse by the Child Protection Team of the Thammasat University Hospital between January 2005 and December 2006 were reviewed. Clinical characteristics and genital findings including photographs of the patients who had a history of penile-vaginal penetration were collected and analyzed, using descriptive statistics. Results: Ninety six patients age 4-18 years (median age 13 years) were recruited. Overall, patients were found to have diagnostic, suspicious, and nonspecific findings of penetrating trauma in 32.3%, 42.7%, and 25.0%, respectively. The diagnostic findings of penetrating trauma included healed hymenal transection or complete cleft (22.9%), absence of hymenal tissue in any portion of the posterior half (5.2%), and acute laceration or ecchymosis of the hymen (4.2%). The suspicious findings were notches or clefts in the posterior half of the hymen extending more than 50% of hymenal diameter (31.3%), labial or perihymenal lacerations, abrasions, or bruises (10.4%), and the posterior hymenal rim less than 1 mm wide (1.0%). The findings of hymenal bumps or mounds, shallow clefts or notches, nonspecific vaginal discharge, and genital erythema were all nonspecific. Conclusions: Only one-third of the patients with a history of penile-vaginal penetration had physical findings indicating vaginal penetrating trauma.
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Thammasat Medical Journal - ธรรมศาสตร์เวชสาร; Vol.8 No.1 January-March 2008; 9-18