The evaluation of emergency gynaecological problems in children - abstract

ABSTRACT

The main reasons for paediatric gynaecological emergency assesment in 60 girls over a 7 year period were vaginal bleeding (61.6 percent), vaginal discharge (21.6 percent), vaginal growths (8.3 percent) and sexual assault (8.3 percent). Lacerations were discovered in 19 girls. Fifteen girls had straddle injuries resulting solely in vulval (external) lacerations. Of the 5 girls who presented with alleged sexual abuse, 3 were 9 to 10 years of age and were found to have vaginal (internal) lacerations; 12 of the 17 girls with prolapsed urethral mucosa presented with vaginal bleeding and of the 13 girls, who complained of vaginal discharge, foreign bodies were located in 4. Two girls with abdominal pain had ovarian tumours and required laparotomy. As it is generally difficult to make a diagnosis on the basis of the presenting complaint and simple examination, all the girls were examined under anaesthesia. Furthermore, it appears that vaginal (internal) lacerations, especially in older girls, carries a high index of suspicion of sexual molestation and so warrants forensic evaluation (AU)