Sexual Abuse as a Cause of Prepubertal Genital Bleeding: Understanding the Role of Routine Physical Examination

Although accidental trauma is the most common mechanism for genital bleeding, sexual abuse should be considered when the patient is prepubertal and/or a vague history of bleeding is provided. Prepubertal female genital exams should be completed routinely; this clinical technique is critical for pedi...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of pediatric & adolescent gynecology 2021-06, Vol.34 (3), p.288-290
Hauptverfasser: Hadley, Julia, Moore, Jessica, Goldberg, Amy
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 290
container_issue 3
container_start_page 288
container_title Journal of pediatric & adolescent gynecology
container_volume 34
creator Hadley, Julia
Moore, Jessica
Goldberg, Amy
description Although accidental trauma is the most common mechanism for genital bleeding, sexual abuse should be considered when the patient is prepubertal and/or a vague history of bleeding is provided. Prepubertal female genital exams should be completed routinely; this clinical technique is critical for pediatricians to assess pubertal progression, to identify pathologies or differences in sexual differentiation, and to narrow a broad differential diagnosis of bleeding. Physical evidence of sexual abuse on exam is rarely found, and therefore the diagnosis relies on a child's disclosure. Physicians should be cognizant of barriers to patient disclosure. In this commentary we aim to provide general pediatricians and trainees with a framework for evaluating genital/vaginal bleeding in prepubertal girls, by discussing the following: (1) the importance of a complete anogenital exam in generating a differential diagnosis; and (2) the possibility of sexual abuse as an etiology with recognition that the disclosure process is complex.
doi_str_mv 10.1016/j.jpag.2021.01.003
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2480278068</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1083318821000036</els_id><sourcerecordid>2480278068</sourcerecordid><originalsourceid>FETCH-LOGICAL-c271t-2cb5f23dec1efddd1129f417c5ab5a2d0c596d16c49992562b38dc85f702b8613</originalsourceid><addsrcrecordid>eNp9kElLBDEQhYMo7n_Ag-TopccsvaTFiw46CoKDyzmkk2rN0JOMSbfovzftqEehoKqo9x7Uh9ARJRNKaHm6mCxW6mXCCKMTkorwDbRLRcWznHO2mWYieMapEDtoL8YFIaQqSrGNdjjPBUuaXeQf4WNQHb5ohghYRazwVI2jb_E8wGpoIPTpPgNnx37ZARjrXs7wszMQYq_cuOL-FfCD7759D37orQM8f_2MVifT1YdaWqd6690B2mpVF-Hwp--j5-urp-lNdnc_u51e3GWaVbTPmG6KlnEDmkJrjKGU1W1OK12oplDMEF3UpaGlzuu6ZkXJGi6MFkVbEdaIkvJ9dLLOXQX_NkDs5dJGDV2nHPghSpYLwipBSpGkbC3VwccYoJWrYJcqfEpK5AhaLuQIWo6gJUlFeDId_-QPzRLMn-WXbBKcrwWQvny3EGTUFpxO9ALoXhpv_8v_ArU6j0A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2480278068</pqid></control><display><type>article</type><title>Sexual Abuse as a Cause of Prepubertal Genital Bleeding: Understanding the Role of Routine Physical Examination</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Hadley, Julia ; Moore, Jessica ; Goldberg, Amy</creator><creatorcontrib>Hadley, Julia ; Moore, Jessica ; Goldberg, Amy</creatorcontrib><description>Although accidental trauma is the most common mechanism for genital bleeding, sexual abuse should be considered when the patient is prepubertal and/or a vague history of bleeding is provided. Prepubertal female genital exams should be completed routinely; this clinical technique is critical for pediatricians to assess pubertal progression, to identify pathologies or differences in sexual differentiation, and to narrow a broad differential diagnosis of bleeding. Physical evidence of sexual abuse on exam is rarely found, and therefore the diagnosis relies on a child's disclosure. Physicians should be cognizant of barriers to patient disclosure. In this commentary we aim to provide general pediatricians and trainees with a framework for evaluating genital/vaginal bleeding in prepubertal girls, by discussing the following: (1) the importance of a complete anogenital exam in generating a differential diagnosis; and (2) the possibility of sexual abuse as an etiology with recognition that the disclosure process is complex.</description><identifier>ISSN: 1083-3188</identifier><identifier>EISSN: 1873-4332</identifier><identifier>DOI: 10.1016/j.jpag.2021.01.003</identifier><identifier>PMID: 33482332</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anogenital exam ; Child ; Child Abuse, Sexual - diagnosis ; Child Abuse, Sexual - psychology ; Child, Preschool ; Diagnosis, Differential ; Disclosure ; Female ; Genital bleeding ; Genitalia, Female - injuries ; Hemorrhage - diagnosis ; Hemorrhage - etiology ; Humans ; Pediatrics ; Physical Examination ; Prepubertal ; Sexual abuse</subject><ispartof>Journal of pediatric &amp; adolescent gynecology, 2021-06, Vol.34 (3), p.288-290</ispartof><rights>2021 North American Society for Pediatric and Adolescent Gynecology</rights><rights>Copyright © 2021 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c271t-2cb5f23dec1efddd1129f417c5ab5a2d0c596d16c49992562b38dc85f702b8613</citedby><cites>FETCH-LOGICAL-c271t-2cb5f23dec1efddd1129f417c5ab5a2d0c596d16c49992562b38dc85f702b8613</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpag.2021.01.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33482332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hadley, Julia</creatorcontrib><creatorcontrib>Moore, Jessica</creatorcontrib><creatorcontrib>Goldberg, Amy</creatorcontrib><title>Sexual Abuse as a Cause of Prepubertal Genital Bleeding: Understanding the Role of Routine Physical Examination</title><title>Journal of pediatric &amp; adolescent gynecology</title><addtitle>J Pediatr Adolesc Gynecol</addtitle><description>Although accidental trauma is the most common mechanism for genital bleeding, sexual abuse should be considered when the patient is prepubertal and/or a vague history of bleeding is provided. Prepubertal female genital exams should be completed routinely; this clinical technique is critical for pediatricians to assess pubertal progression, to identify pathologies or differences in sexual differentiation, and to narrow a broad differential diagnosis of bleeding. Physical evidence of sexual abuse on exam is rarely found, and therefore the diagnosis relies on a child's disclosure. Physicians should be cognizant of barriers to patient disclosure. In this commentary we aim to provide general pediatricians and trainees with a framework for evaluating genital/vaginal bleeding in prepubertal girls, by discussing the following: (1) the importance of a complete anogenital exam in generating a differential diagnosis; and (2) the possibility of sexual abuse as an etiology with recognition that the disclosure process is complex.</description><subject>Anogenital exam</subject><subject>Child</subject><subject>Child Abuse, Sexual - diagnosis</subject><subject>Child Abuse, Sexual - psychology</subject><subject>Child, Preschool</subject><subject>Diagnosis, Differential</subject><subject>Disclosure</subject><subject>Female</subject><subject>Genital bleeding</subject><subject>Genitalia, Female - injuries</subject><subject>Hemorrhage - diagnosis</subject><subject>Hemorrhage - etiology</subject><subject>Humans</subject><subject>Pediatrics</subject><subject>Physical Examination</subject><subject>Prepubertal</subject><subject>Sexual abuse</subject><issn>1083-3188</issn><issn>1873-4332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kElLBDEQhYMo7n_Ag-TopccsvaTFiw46CoKDyzmkk2rN0JOMSbfovzftqEehoKqo9x7Uh9ARJRNKaHm6mCxW6mXCCKMTkorwDbRLRcWznHO2mWYieMapEDtoL8YFIaQqSrGNdjjPBUuaXeQf4WNQHb5ohghYRazwVI2jb_E8wGpoIPTpPgNnx37ZARjrXs7wszMQYq_cuOL-FfCD7759D37orQM8f_2MVifT1YdaWqd6690B2mpVF-Hwp--j5-urp-lNdnc_u51e3GWaVbTPmG6KlnEDmkJrjKGU1W1OK12oplDMEF3UpaGlzuu6ZkXJGi6MFkVbEdaIkvJ9dLLOXQX_NkDs5dJGDV2nHPghSpYLwipBSpGkbC3VwccYoJWrYJcqfEpK5AhaLuQIWo6gJUlFeDId_-QPzRLMn-WXbBKcrwWQvny3EGTUFpxO9ALoXhpv_8v_ArU6j0A</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Hadley, Julia</creator><creator>Moore, Jessica</creator><creator>Goldberg, Amy</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202106</creationdate><title>Sexual Abuse as a Cause of Prepubertal Genital Bleeding: Understanding the Role of Routine Physical Examination</title><author>Hadley, Julia ; Moore, Jessica ; Goldberg, Amy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c271t-2cb5f23dec1efddd1129f417c5ab5a2d0c596d16c49992562b38dc85f702b8613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anogenital exam</topic><topic>Child</topic><topic>Child Abuse, Sexual - diagnosis</topic><topic>Child Abuse, Sexual - psychology</topic><topic>Child, Preschool</topic><topic>Diagnosis, Differential</topic><topic>Disclosure</topic><topic>Female</topic><topic>Genital bleeding</topic><topic>Genitalia, Female - injuries</topic><topic>Hemorrhage - diagnosis</topic><topic>Hemorrhage - etiology</topic><topic>Humans</topic><topic>Pediatrics</topic><topic>Physical Examination</topic><topic>Prepubertal</topic><topic>Sexual abuse</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hadley, Julia</creatorcontrib><creatorcontrib>Moore, Jessica</creatorcontrib><creatorcontrib>Goldberg, Amy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric &amp; adolescent gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hadley, Julia</au><au>Moore, Jessica</au><au>Goldberg, Amy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sexual Abuse as a Cause of Prepubertal Genital Bleeding: Understanding the Role of Routine Physical Examination</atitle><jtitle>Journal of pediatric &amp; adolescent gynecology</jtitle><addtitle>J Pediatr Adolesc Gynecol</addtitle><date>2021-06</date><risdate>2021</risdate><volume>34</volume><issue>3</issue><spage>288</spage><epage>290</epage><pages>288-290</pages><issn>1083-3188</issn><eissn>1873-4332</eissn><abstract>Although accidental trauma is the most common mechanism for genital bleeding, sexual abuse should be considered when the patient is prepubertal and/or a vague history of bleeding is provided. Prepubertal female genital exams should be completed routinely; this clinical technique is critical for pediatricians to assess pubertal progression, to identify pathologies or differences in sexual differentiation, and to narrow a broad differential diagnosis of bleeding. Physical evidence of sexual abuse on exam is rarely found, and therefore the diagnosis relies on a child's disclosure. Physicians should be cognizant of barriers to patient disclosure. In this commentary we aim to provide general pediatricians and trainees with a framework for evaluating genital/vaginal bleeding in prepubertal girls, by discussing the following: (1) the importance of a complete anogenital exam in generating a differential diagnosis; and (2) the possibility of sexual abuse as an etiology with recognition that the disclosure process is complex.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33482332</pmid><doi>10.1016/j.jpag.2021.01.003</doi><tpages>3</tpages></addata></record>
fulltext fulltext
identifier ISSN: 1083-3188
ispartof Journal of pediatric & adolescent gynecology, 2021-06, Vol.34 (3), p.288-290
issn 1083-3188
1873-4332
language eng
recordid cdi_proquest_miscellaneous_2480278068
source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Anogenital exam
Child
Child Abuse, Sexual - diagnosis
Child Abuse, Sexual - psychology
Child, Preschool
Diagnosis, Differential
Disclosure
Female
Genital bleeding
Genitalia, Female - injuries
Hemorrhage - diagnosis
Hemorrhage - etiology
Humans
Pediatrics
Physical Examination
Prepubertal
Sexual abuse
title Sexual Abuse as a Cause of Prepubertal Genital Bleeding: Understanding the Role of Routine Physical Examination
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T01%3A36%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Sexual%20Abuse%20as%20a%20Cause%20of%20Prepubertal%20Genital%20Bleeding:%20Understanding%20the%20Role%20of%20Routine%20Physical%20Examination&rft.jtitle=Journal%20of%20pediatric%20&%20adolescent%20gynecology&rft.au=Hadley,%20Julia&rft.date=2021-06&rft.volume=34&rft.issue=3&rft.spage=288&rft.epage=290&rft.pages=288-290&rft.issn=1083-3188&rft.eissn=1873-4332&rft_id=info:doi/10.1016/j.jpag.2021.01.003&rft_dat=%3Cproquest_cross%3E2480278068%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2480278068&rft_id=info:pmid/33482332&rft_els_id=S1083318821000036&rfr_iscdi=true