Children With Anogenital Symptoms and Signs Referred for Sexual Abuse Evaluations

Kellogg, Nancy D.; Parra, Juan M.; Menard, Shirley W.

doi:10.1001/archpedi.152.7.634

Cited by 46 publications

(24 citation statements)

References 25 publications

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“…Even among the published studies, wide differences have existed between the rate of abnormal or supportive findings reported among children examined for suspected sexual abuse, from 50% to 90%, [14][15][16][17] to 15-20% in many reports in the 1990s, [18][19][20] to less than 4% in large series published since 2000 [21,22]. In our study, a supportive medical opinion was found among 52% of children less than 10 years.…”

Section: Discussioncontrasting

confidence: 55%

“…Medical literature on opinions given by experts on sexual abuse based on genital findings is scarce and limited to case reports or descriptive studies [12][13][14][15][16][17][18][19][20][21][22]. Even among the published studies, wide differences have existed between the rate of abnormal or supportive findings reported among children examined for suspected sexual abuse, from 50% to 90%, [14][15][16][17] to 15-20% in many reports in the 1990s, [18][19][20] to less than 4% in large series published since 2000 [21,22].…”

Section: Discussionmentioning

confidence: 99%

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An Expert and Expectations: A review on Medico-legal opinions in alleged sexual abuse victims

Edirisinghe¹,

Kitulwatte²

2016

Medico-Legal J SL

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Introduction An expert's role is to guide the courts in matters related to a particular speciality. In a case of alleged sexual assault an expert is expected to document the history, examination findings and collect available evidence in order to corroborate accounts of sexual assault for courts of law. However in many instances, the medico-legal evidence has shown its limitations and inconsistencies of expert evidence which are known to result in miscarriage of justice.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

An Expert and Expectations: A review on Medico-legal opinions in alleged sexual abuse victims

Edirisinghe¹,

Kitulwatte²

2016

Medico-Legal J SL

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“…Because many normal anatomic variations, congenital malformations and infections, or other medical conditions may be confused with abuse, familiarity with these other causes is important. 41,42 Physicians should be aware that child sexual abuse often occurs in the context of other family problems, including physical abuse, emotional maltreatment, substance abuse, and family violence. If these problems are suspected, referral for a more comprehensive evaluation is imperative and may involve other professionals with expertise needed for evaluation and treatment.…”

Section: Diagnostic Considerationsmentioning

confidence: 99%

The Evaluation of Sexual Abuse in Children

Kellogg¹

2005

Pediatrics

354

110

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ABSTRACT. This clinical report serves to update the statement titled "Guidelines for the Evaluation of Sexual Abuse of Children," which was first published in 1991 and revised in 1999. The medical assessment of suspected sexual abuse is outlined with respect to obtaining a history, physical examination, and appropriate laboratory data. The role of the physician may include determining the need to report sexual abuse; assessment of the physical, emotional, and behavioral consequences of sexual abuse; and coordination with other professionals to provide comprehensive treatment and follow-up of victims. Pediatrics 2005;116:506-512; child sexual abuse, sexually transmitted diseases, medical assessment.

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“…Também não foi obser-vado qualquer distúrbio de comportamento por parte das crianças ou de seus pais que nos levasse a suspeitar de abuso sexual. Além disso, poucas crianças são encaminhadas para avaliação mais detalhada de um possível abuso baseado somente em sinais e sintomas apresentados 17 . Como não foi possível a realização de cultura para confirmar o diagnóstico, não podemos afirmar com certeza de que se tratavam de casos de gonorréia.…”

Section: Wanderley Et Alunclassified

Avaliação Clínica e Laboratorial de Crianças e Adolescentes com Queixas Vulvovaginais

Wanderley¹,

Magalhães²,

Trindade³

2000

Rev. Bras. Ginecol. Obstet.

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IntroduçãoAs queixas vulvovaginais na infância e adolescência são um motivo de constantes visitas ao médico, pediatra e/ou ginecologista, que, quase sempre despreparados para orientar estes casos, muitas vezes tomam condutas intempestivas prescrevendo medicamentos, freqüentemente antibióticos de largo espectro, sem necessidade.Além da falta de preparo no atendimento destes casos, não há ainda um entendimento claro do complexo meio ambiente vaginal e de sua homeostase e das interrelações com os mecanismos de defesa do hospedeiro, que são distintos em meninas pré-púberes e naquelas que já menstruaram 1,2 . A flora vaginal normal é predominantemente aeróbica, sendo que os lactobacilos produtores de peróxido de hidrogênio são as bactérias mais comumente observadas. Em mulheres no menacme o pH vaginal normal é menor que 4,5 devido à produção de ácido lático. Ao serem estimuladas pelo estrogênio, as células epiteliais vaginais, ricas em glicogênio, decompõe-no em monossacarídeos, que são convertidos em ácido lático pelos lactobacilos 3,4 . Em meninas pré-púberes a presença de vagina atrófica não-estrogenizada, com pH de 6,5 a 7,5, a ausência de coxins adiposos vulvares e de pelos pubianos, a curta distância entre a vagina e o ânus, a pequena abertura do hímen obstruindo a saída de secreções vaginais e a diminuição dos mecanismos imunes locais são fatores predispo-

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Children With Anogenital Symptoms and Signs Referred for Sexual Abuse Evaluations

Cited by 46 publications

References 25 publications

An Expert and Expectations: A review on Medico-legal opinions in alleged sexual abuse victims

An Expert and Expectations: A review on Medico-legal opinions in alleged sexual abuse victims

The Evaluation of Sexual Abuse in Children

Avaliação Clínica e Laboratorial de Crianças e Adolescentes com Queixas Vulvovaginais

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