HD FS 258 Lecture Notes - Lecture 12: Pediatrics, Foley Catheter, Sexually Transmitted Infection
17 Jan 2017
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Medical evaluation of sexual abuse guest lecture (dr. frasier) Only 4% of all children referred for medical evaluations of sexual abuse have abnormal examinations: 5. 5% with penetration. Medical, legal and social professionals rely too heavily on the medical exam. History from the child remains the single more important diagnostic feature. Fresh laceration of the posterior fourchette, not involving the hymen. Must be differentiated from dehisced labial adhesion or failure of midline fusion. May also be caused by accidental injury or consensual sexual intercourse in adolescents. These findings are difficult to assess unless an acute injury was previously documented in the same location: peri-anal scar. May be due to other medical conditions such as: Previous medical procedures: scar of posterior fourchette or fossa. Pale areas in the midline may also be due to: Injuries compression injury if a history is given indicative of blunt force penetrating trauma or from abdominal/pelvic. Laceration (tear, partial or complete) of the hymen, acute.
