Genital trauma and vaginal bleeding: is it a lapse of time issue? A case report of a prepubertal girl and review of the literature
详细信息 查看全文
- 作者：Marianna Russo ; Melissa Rosa-Rizzotto…
- 关键词：Child sexual abuse ; Injury timing ; Vaginal bleeding ; Wound healing
- 刊名：International Journal of Legal Medicine
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：131
- 期：1
- 页码：185-189
- 全文大小：
- 刊物类别：Medicine
- 刊物主题：Forensic Medicine; Medical Law; Medicine/Public Health, general;
- 出版者：Springer Berlin Heidelberg
- ISSN：1437-1596
- 卷排序：131
文摘
Child victims of sexual abuse may present with physical findings whose interpretation requires the most exhaustive evaluation and an accurate collection of a detailed history. Genital bleeding is usually considered as an acute sign, related to a trauma that occurred shortly before its appearance. We report a case of a 34-month-old child who was referred to the emergency room with a significant vaginal hemorrhage, originating from a wide laceration of the posterior fourchette, and a negative history for accidental trauma. The characteristics of the lesion, compared to the temporal evolution of the healing process, and the witnesses’ depositions led us to assume that the time elapsed between the abusive event and the physical examination was longer in respect to what had appeared at the first sight. The judicial reconstruction of the events confirmed our assumption, allowing the charge of the right abuse perpetrator. As the literature regarding this eventuality is very poor, we report this case to stress the importance for physicians to consider that an active bleeding may be the manifestation of a trauma that occurred very long before.