CMAS 258 Lecture Notes - Lecture 13: Frenulum Of Labia Minora, Hymen, Penetrating Trauma
Document Summary
Conclusion: only a few vulvar or hymenal findings are reliable indicators of sexual abuse among pre-pubertal girls. Furthermore, these findings are infrequently among children examined at a sexual assault center. In fact, findings strongly suggestive of sexual abuse were observed in <5% of abused children. Therefore, the genital exam is unlikely to support or negate a child"s history. Thus it is critical that legal experts focus on the child"s history as the primary evidence of sexual abuse. Results: 96. 3% had normal medical exams, included disclosed abuse, behavioral changes, exposure to abuse or medical conditions, 95. 6% of children reporting abuse were normal, 99. 8% who were referred for behavioral changes or exposure to abuse were normal. Acute trauma: fresh laceration of the posterior fourchette, not involving the hymen, must be differentiated from dehisced labial adhesion or failure of midline fusion, may also be caused by accidental injury or consensual sexual intercourse in adolescents.
