Female pediatric and adolescent genitalia trauma: a retrospective analysis of the National Trauma Data Bank

Abstract

Purpose Pediatric genitalia injury represents 0.6% of all pediatric trauma. It is crucial for providers to understand whether pediatric patients are at risk for violent mechanisms, such as rape, assault, or other abuse. Therefore, we sought to perform a large database analysis of pediatric and adolescent female genitalia trauma, comparing mechanisms of injury (i.e., sexual abuse) and need for operative intervention between adolescent and pediatric cohorts. Methods The National Trauma Data Bank was queried (years 2007-2015) for female patients ≤ 16 years old with external genitalia (vaginal or vulvar) trauma. Two groups were compared: pediatrics (< 12 years old) and adolescents (12-16 years old). Results Out of 303,992 female patients, 3206 (1.1%) were identified to have genitalia trauma with the majority being pediatric patients (92.1%) and with injury to the vagina (62.6%). Pediatric patients with vaginal injury were less likely to be victims of rape (4.1% vs. 17.3%, p < 0.001) and assault (2.1% vs. 7.2%, p < 0.001) but more likely to be victims of other abuse (9.5% vs. 3.4%, p = 0.003). More of the adolescent patients with vaginal trauma required repair (58.7% vs. 43.2%, p < 0.001). Pediatric patients with injury to the vulva were less likely to be victims of rape (0.7% vs. 2.8%, p = 0.01) and motor vehicle accidents (4.2% vs. 11.0%, p < 0.001). Conclusion Genitalia trauma occurs in 1.1% of pediatric and adolescent trauma cases with the vagina being more commonly injured compared to the vulva. Adolescent patients with vaginal injuries were more likely to be victims of rape and assault and required repair more often, while those with vulvar injuries were more likely due to motor vehicle accidents. Health care providers must be aware of these at-risk populations and the differences between them to identify female victims of violence and provide resources to assist with recovery.

Ruptur Perineum Grade 3A Post Trauma: Laporan Kasus

“…Studi yang telah dilakukan oleh Fan et al (2020) menjelaskan kejadian cedera pada perineum dan anorektal, dalam penatalaksanaan bedah jarang terjadi dan hanya dilakukan pada 9% dari kejadian cedera genital. Namun, dalam tinjauan retrospektif, Spitzer dkk.…”

“…menemukan bahwa sekitar 21% dari anak-anak yang akibat trauma yang tidak disengaja dengan keterlibatan vulva membutuhkan penatalaksanaan bedah. Sebaliknya, penelitian menemukan hampir 50% dari semua pasien anak perempuan dengan trauma genitalia eksterna menjalani penatalaksanaan operatif (Fan et al, 2020). Laporan kasus yang penulis sajikan ini, akan membahas lebih lanjut mengenai perjalanan penilaian klinis penulis pada pasien anak usia 9 tahun yang di rawat inap dengan diagnosis rupture perineum grade 3A akibat trauma, sehingga membuat kasus ini cukup menarik untuk dibahas.…”

Haematocolpos and Secondary Hematometra Due to Imperforate Hymen: Diagnosis and Treatment

“…2 In addition to congenital malformations, the imperforate hymen can occur due to scar tissue due to genital trauma during sexual abuse or infection. 4,5 The incidence of imperforate hymen is very rare, ranging from 0.05-0.1% and most cases diagnosed in adolescence are rarely diagnosed in the neonatal period. 2 Some young adolescents are asymptomatic until menstruation begins, namely symptoms of lower abdominal pain and urinary retention.…”

Mechanism of Injury and Age Predict Operative Intervention in Pediatric Perineal Injury

“…Most studies consist of case series or large deidentified databanks isolated to the effect of trauma on one set of reproductive organs or another. 2,3,[10][11][12] Previous research on pediatric perineal trauma involved characterizing mechanisms, indications for operative intervention and exploration, and differences in presentation and management based on age. 3,7,8 Recent clinical management algorithms have identified approaches to standardize management of perineal trauma based on the Genital Injury Scale and anatomic structures injured.…”

“…P erineal injury is uncommon in pediatric patients, accounting for only 0.2% to 6% of all pediatric injuries. [1][2][3] Perineal injuries are associated with high levels of pain and psychological distress in both children and parents. 4,5 Straddle injuries, typically resulting from falls, other blunt injuries, usually from motor vehicle accidents, and penetrating injuries from foreign bodies represent the broad spectrum of injuries in this region of the body.…”