Has This Prepubertal Girl Been Sexually Abused?

Abstract

Vaginal discharge as well as posterior hymenal transections, deep notches, and perforations raise the suspicion for sexual abuse in a prepubertal girl, but the findings do not independently confirm the diagnosis. Given the broad 95% confidence intervals around the likelihood ratios for the presence of findings along with the low or unknown sensitivity of all physical examination findings evaluated, the physical examination cannot independently confirm or exclude nonacute sexual abuse as the cause of genital trauma in prepubertal girls.

Is early detection of abused children possible?: a systematic review of the diagnostic accuracy of the identification of abused children

“…Furthermore, the diagnostic accuracy of markers was not always estimated, the analysis being limited to estimating the association between a marker and maltreatment. Similarly, diagnostic accuracy of genital examination for identifying sexually abused prepubertal girls was reviewed [10], but tools only identified children who were victims of a severe form of sexual abuse (genital contact with penetration). Furthermore, the sensitivity for several potential markers, such as hymeneal transections, deep notches or perforations, was never reported.…”

Transmissão de verrugas anogenitais em crianças e associação com abuso sexual

“…It is estimated that 12% to 25% of girls and 8% to 10% of boys suffer some form of sexual abuse up to 18 years of age 3 . Girls are at greater risk of facing the problem, while boys are more likely to hide its occurrence 4 . The author of the sexual violence is generally known to the child and close family, sometimes responsible for its protection, often an expressive number of cases are performed by the biological father, grandfather or stepfather 5 .…”

Physical Examination in Child Sexual Abuse

“…Berkoff et al, in their systematic review of the literature on sexual abuse of prepubertal girls, published in 2008, found only 11 articles that were suitable for inclusion (31). Their conclusions were as follows:…”