Genital injury in girls — accidental or not?
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For 33 months a prospective study was made of girls attending a paediatric accident and emergency department with genital injury. The clinical features were related to age and the stated mechanism of the injury. Indicators for non-accidental injury were sought. A clear history was given in 82 of 87 girls to account for the findings on examination. Straddle injuries occurred in 74, accidental penetrating injuries in 5, stretch injuries in 3, and 2 had self-inflicted scratch injuries. Sexual abuse was alleged by 3 girls. Surgery was required in 6. Accidental injuries to the genital area are common and should have a clear history, with findings on examination consistent with that history. An absent or vague history or injury to the hymen, fourchette, or perineum must raise suspicions of child sexual abuse.
Key wordsGenital injury Sexual abuse
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