Vaginal bleeding in young children

Abstract

Abstract. To evaluate prospectively vaginal bleeding in young children with emphasis on the cause, management and outcome, we analyzed the data of all children aged under 10 years old who presented with vaginal bleeding at the King Chulalongkorn Memorial Hospital between 1981 and 2000. There were 55 girls presenting with vaginal bleeding with variable degrees of severity. In 41 of the 55 girls (74.5%), the bleeding resulted from a local lesion of the genital tract. Genital tumors were seen in four girls, ie hemangioma of the vulva, sarcoma botryoides of the vagina, functional ovarian cyst and granulosa cell tumor of the ovary. In the remaining 14 girls (25.5%), the bleeding originated from systemic hormonal etiology. In one girl with precocious puberty, it was associated with hypothyroidism, whereas in the other six girls it was due to constitutional causes. In addition, the cause of bleeding in 10 girls was the vaginal manifestation of leeches, which is a unique problem for Thailand. Although vaginal bleeding in young children is rare, it can be an alarming clinical presentation, and serious underlying causes should be excluded. Prompt and correct diagnosis will lead to successful management.

A Rare Cause of Hypovolemic Shock in Prepubertal Girl: Vaginal Leech Infestation

“…Although there have been a few rare cases of vaginal bleeding due to leech infestation especially in tropical areas [2, 7, 9, 10], this has never been reported in Morocco. Review of the literature reveals that most girls present with vaginal bleeding after swimming in local bodies of water and that the vaginal wall and the vulva were the most common sites of leech bite [7].…”

Intraperitoneal leech: A rare complication of leech bite

“…[18–20] Aribarg et al .,[19] from Bangkok have reported the largest series of 10 children with vaginal bleeding due to leech bite. In their report, nine cases were diagnosed by a history of leech dropping out of the vagina, accompanied by vaginal bleeding.…”

Lower Genital Tract Disease in Children and Adolescents—A review

“…A rare cause in the U.S., but a common cause in the tropics, is a leech swimming into the vagina from swimming in a river or pond. 68 Uterine neoplasms usually seen in adults have appeared as sporadic reports, including endometrial carcinomas and malignant mixed Müllerian tumors. Of 52 cases of vaginal bleeding in girls 10 years or under reviewed by Hill et al, 69 54% were due to a local lesion, 11% had malignant genital tumors, 21% of the children presented with precocious pubertal signs, and in 25%, no diagnosis was made.…”