Genital Trauma

Pokorny, Susan F.

doi:10.1097/00003081-199703000-00023

Cited by 26 publications

(21 citation statements)

References 4 publications

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“…All reports stress the overwhelming importance of the history. [2][3][4][5] In most cases of accidental injury, the hymen is not involved. Exceptions are rare cases of accidental penetrating injuries.…”

Section: Discussionmentioning

confidence: 99%

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Genital Injuries in Prepubertal Girls From Inline Skating Accidents

Herrmann

Crawford²

2002

Pediatrics

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ABSTRACT. We report 2 cases where accidents from inline skating resulted in significant genital injury to female children. When genital trauma occurs in children, it frequently raises the concern that sexual abuse might have caused the injury. Historical information provided by the child and others must be compared with the injuries to understand whether an injury may be the result of abuse. We characterize the nature of the genital injuries of our cases as being caused by an accidental "rapid-splits" type mechanism while children were using inline skates. We conclude that the reported accidental mechanism caused the identified injuries. Distinguishing accidental from abusive causes of genital trauma is critical. We report these cases, as there are no reports in the literature regarding this accidental mechanism of injury. Pediatrics 2002;110(2). URL: http://www. pediatrics.org/cgi/content/full/110/2/e16; child sexual abuse, differential diagnosis, inline skating injuries, children.G enital trauma in prepubertal children, especially when it involves the hymen, is often considered to be an important physical indicator of child sexual abuse. A limited number of reports of accidental injuries to the anogenital area in children describe the mechanisms of trauma in relation to the identified injuries. These studies stress the importance of clear, consistent, and credible historical information. [1][2][3][4][5][6][7][8] There have been no reports identifying inline skating accidents as resulting in significant genital trauma so far. Both cases we report were witnessed events. The historical information that was provided to the health care providers was clear and consistent, both by the patient as well as by the observers. CASE REPORTS Case 1While using inline skates, an unsupervised 8-year-old girl fell in a manner where her legs rapidly abducted in a "splits-type" mechanism. She was not able to recall whether there had been any object on the paved street onto which she fell. The accident was witnessed by a 6-year-old sister and a 7-year-old cousin. The girl noticed immediate pain and bleeding. Application of a clean cloth with gentle pressure (by the child's grandmother) and bed rest stopped the bleeding, so no medical care was initially sought. The girl was on a weekend visit to her grandmother at the time of the event. When she returned to her mother's care the next day, the bleeding recurred and the anogenital area remained uncomfortable; urination was moderately painful. The mother brought the child to a pediatric hospital emergency department ϳ24 hours after the event.Examination revealed a deep midline splitting injury from the anal verge to the perineum and an extensive hematoma from the perineum to the right lower labia majora and into the fossa navicularis. The hematoma reached the hymen, causing a few petechiae on the hymenal membrane. The hymen itself was not further injured (Fig 1). The girl underwent surgical repair of the injury. The intraoperative inspection of the anal sphincter and the vagina were un...

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Section: Discussionmentioning

confidence: 99%

“…These studies stress the importance of clear, consistent, and credible historical information. [1][2][3][4][5][6][7][8] There have been no reports identifying inline skating accidents as resulting in significant genital trauma so far. Both cases we report were witnessed events.…”

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confidence: 99%

Genital Injuries in Prepubertal Girls From Inline Skating Accidents

Herrmann

Crawford²

2002

Pediatrics

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“…Outdoors, these injuries may be associated with bicycles, fences, playground equipment, trees, trailer hitches, ladders, and the edges of above-ground pools. 4,6,7 Indoors, injuries may be related to climbing on counters, cabinet doors or furniture, or into bathtubs. 5e7 Falls.…”

mentioning

confidence: 99%

“…Genital trauma may be associated with a fall onto an object, such as a toy. 1,4,7 There have also been reports of such trauma from falling into the water with legs abducted while water-or jetskiing. 6 Motor vehicle accidents.…”

mentioning

confidence: 99%