Prepubertal Vaginal Bleeding: An Inpatient Series from a Single Center in Fujian China

Zhang, Jinna; Zhang, Bing; Su, Yanzhao; Guo, Sang; Liu, Chaobin; Bai, Jun; Xie, Xi

doi:10.1016/j.jpag.2019.11.009

Cited by 12 publications

(11 citation statements)

References 16 publications

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“…Weight loss was observed in 69 patients with the percentage frequency of 46 %, back pain was present in 47 patients with frequency of 31%, indigestion problem was indicated in 87 patients having frequency of 58%, the number of patients suffering with muscle pain were 101 with frequency of 67%, Unexplained bleeding, a symptom present in the patients in severe condition was observed with frequency of 6% only in 9 patients, swallowing was observed in the 16 patients having the frequency of 10%, the frequency of patients with urination problems was 24% in 37patients, a lump/ lumps were observed in 26 patients with 17% frequency Unexplained anaemia is also as a most common symptom of the cancer and was analysed in 97 patients with a frequency of 64%, hoarseness or the change in voice is not so common symptom present in only 13 patients with 8% frequency, skin change was seen in 8 patient suffering from skin cancer with a frequency of 5% only. The patients who had non-healing sores were 52 with 34% frequency, vaginal bleeding [49]is also one of the severe symptoms present in females suffering from that cancer and the symptom was observed in the 23 females with frequency of 15% and lastly the breast lump is associated with females suffering from breast cancer were 33 with a percentage frequency of 22% as given in the…”

Section: Table 1 Tumor Markers In Cancer Diagnostics and Their Relati...mentioning

confidence: 99%

Blueprinting in Coherence to Diagnostic Momentum: On Account of Cancer Detection in Bahawalpur Community

Manzoor¹,

Dilshad²,

Hassan³

et al. 2022

PJBB

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In the current era, cancer is a critical health problem. Purpose of the study was symptomatic analysis of cancer patients and medical evaluation of hematological and biochemical parameters of patients from different geographical areas of district Bahawalpur. A crosssectional study was done to find out the diagnostic timeliness in cancer patients. Out of 150 cancer patients, 53% patients were males and 47% females with age from 15 years to 75 years. It has been shown that 76% of patients represent major symptoms of cancer while 24% of patients were showing minor symptoms. Furthermore, cancer patients were disturbed metabolical, hematological, and biochemical profiling. There were 83% of patients with anemia and 17% patients have normal hemoglobin count in males and 85 % of total female patients have low hemoglobin level while rest of 15% have normal hemoglobin count. Illiteracy is positively influencing the factors responsible for causing cancer with 53%, whereas 23% less than primary level education and only 1% of patients had completed their graduation. There were 31% of the patients lies in upper lower class of society, 28% lower class, Lower middle class 19%, middle class 14%, upper middle class 7% and only 1 % patients belong to high social status. This study will help to diagnosis the early cancer detection via biochemical and metabolic profiling.

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Section: Table 1 Tumor Markers In Cancer Diagnostics and Their Relati...mentioning

confidence: 99%

Blueprinting in Coherence to Diagnostic Momentum: On Account of Cancer Detection in Bahawalpur Community

Manzoor¹,

Dilshad²,

Hassan³

et al. 2022

PJBB

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“…16 A vaginal foreign body is not always identified and cannot be excluded on ultrasound. Toilet paper was identified in both our patients with a foreign body and was also the most common foreign body reported in the series of Zhang et al 11 Saline irrigation of the vagina in order to flush it out of the vagina without general anaesthetic has been described for suspected toilet paper foreign body. 17 An alternative approach would be a trial of vulvovaginitis treatment with vinegar baths and encourage splashing of water to the genital area to 'flush' the vagina.…”

Section: Discussionmentioning

confidence: 56%

“…1,2 It had been suggested in the past that all prepubertal vaginal bleeding necessitated an examination under anaesthesia (EUA), 3 but this statement has been increasingly challenged. 2,4 Research on vaginal bleeding in prepubertal children is limited to case reports of unusual causes [5][6][7][8] and case series, of which only three are recent [9][10][11] while the rest were published several decades ago. 3,[12][13][14] Optimal management should aim at identifying conditions with a poor outcome or requiring a specific treatment, and avoiding over-investigating benign and self-resolving conditions.…”

Section: What This Paper Addsmentioning

confidence: 99%

Vaginal bleeding in children: A retrospective audit at a tertiary paediatric gynaecology service

Drever

Peek

Moussaoui

et al. 2023

J Paediatrics Child Health

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Aim The aim of this study was to describe the clinical features and investigations of vaginal bleeding in prepubertal children. Methods We performed a retrospective case series of children under the age of 10 who presented with vaginal bleeding to our institution between 2018 and 2019. Results There were 32 cases identified during the timeframe, with a mean age of 5.5 years (standard deviation 3.2 years, range 5.5 days to 9.6 years). Vulvovaginitis was the most common diagnosis (n = 12, 37.5%), followed by precocious puberty (n = 5, 15.6%). Uncommon but serious causes were vaginal rhabdomyosarcoma (n = 1), and sexual abuse (one patient presenting with gonorrhoea and one with a non‐accidental injury). Vaginoscopy was performed in nine patients (28.1%) for various reasons, and a vaginal foreign body was identified in two patients (6.3%). All the patients who had a serious cause of bleeding (neoplasm or sexual assault) or who required specific treatment (precocious puberty, lichen sclerosus, urethral prolapse) presented with red flags on history and/or examination: recurrent episodes of vaginal bleeding, heavy bleeding, associated general symptoms (poor feeding and growth), presence of thelarche, abdominal mass, associated profuse vaginal discharge and abnormal genital examination (skin changes, urethral prolapse or protruding mass from the vagina). Conclusions A thorough history‐taking and clinical examination aiming at identifying red flags may help to discriminate between benign causes of vaginal bleeding, where no further investigations are indicated, and alternative diagnoses with a poor outcome and/or requiring specific treatment and additional investigations.

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“…Relatives and health-care professionals tend to relate this symptom to acute trauma, and suspicions of recent sexual violence, primarily penetration, frequently emerge, especially when there is no history of accidental trauma. In contrast to the “myth” that (vaginal) penetration is one of the main reasons for vaginal bleeding in children, Zhang et al [ 11 ] showed that predominant causes for vaginal bleeding in girls aged from 10 month to 10 years are foreign bodies, followed by vulvovaginitis and accidental vulvar trauma. Kelly et al [ 12 ] report that physical symptoms such as vaginal bleeding were of no value in discriminating sexually abused children from those who had not been abused; and Russo et al [ 13 ] pointed out that even bleeding from injuries after sexual violence could be delayed by several hours.…”

Section: Discussionmentioning

confidence: 99%

Rare (uro-)genital pathologies in young girls mimicking sexual abuse

Schaul

Schwark

2021

Int J Legal Med

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Examinations of young children for suspicions of sexual abuse are challenging for the involved medical specialists because the consequences of the interpretation of the findings can be severe and dramatic. A broad knowledge of differential diagnoses including rare pathologies like urethral prolapse and failure of the midline fusion of the perineum, known as perineal groove, is essential in order to avoid unnecessary diagnostics and treatment, prejudgment, and to reduce patient family’s anxiety. We report two independent cases of girls aged 7 months and 5 years suffering from these rare pathologies, one presenting with painless lower genital tract bleeding, the other showing a lesion of the perineum as random finding during a neuropediatrician’s consultation. In both cases, the pathologies were initially misdiagnosed as injuries due to sexual assault, and judicial investigation procedures were initiated. In this paper, the characteristic symptoms and morphology of urethral prolapse and perineal groove are presented to enhance the awareness of these pathologies among forensic experts and help to establish the correct diagnosis.

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Prepubertal Vaginal Bleeding: An Inpatient Series from a Single Center in Fujian China

Cited by 12 publications

References 16 publications

Blueprinting in Coherence to Diagnostic Momentum: On Account of Cancer Detection in Bahawalpur Community

Blueprinting in Coherence to Diagnostic Momentum: On Account of Cancer Detection in Bahawalpur Community

Vaginal bleeding in children: A retrospective audit at a tertiary paediatric gynaecology service

Rare (uro-)genital pathologies in young girls mimicking sexual abuse

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