Genital trauma in prepubertal girls and adolescents

Rope swing injuries resulting in vulvar trauma

BACKGROUND

River tree rope swings are popular for recreation along inland lakes and rivers, but not without hazard. In a comprehensive review of injuries related to rope swings, genital injuries accounted for nearly 3 percent.

CASE

We describe significant genital injuries, with laceration and avulsion of the labia and a large vulvar hematoma in 2 young women as a consequence of rope swing use.

SUMMARY AND CONCLUSIONS

Visitors to inland waterways need to be cognizant of the hazards of rope swings and health care professionals should consider this mechanism of injury when confronted with vulvar trauma.

Pediatric genital injury: an analysis of the National Electronic Injury Surveillance System

OBJECTIVE

To describe the characteristics of pediatric genital injuries presenting to United States emergency departments (EDs).

METHODS

A retrospective cohort study utilizing the U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS) from 1991-2010 to evaluate pediatric genital injuries was performed.

RESULTS

Pediatric genital injuries represented 0.6% of all pediatric injuries with the incidence of injuries rising through the period studied, 1991-2010. The mean age at injury was 7.1 years old and was distributed 56.6% girls and 43.4% boys. A total of 43.3% had lacerations and 42.2% had contusions/abrasions. The majority of injuries occurred at home (65.9%), and the majority of patients (94.7%) were treated and released from the hospital. The most common consumer products associated with pediatric genital trauma were: bicycles (14.7% of all pediatric genital injuries), bathtubs (5.8%), daywear (5.6%), monkey bars (5.4%), and toilets (4.0%).

CONCLUSION

Although pediatric genital injuries represent a small proportion of overall injuries presenting to the emergency department, genital injuries continue to rise despite public health measures targeted to decrease childhood injury. Our results can be used to guide further prevention strategies for pediatric genital injury.

Child abuse pediatrics: prevention, evaluation, and treatment

PURPOSE OF REVIEW

This review is designed to update the general pediatrician with information about current child maltreatment literature. The authors have selected salient articles, which inform daily practice of any professional involved in the care of children who may be at risk of child abuse.

RECENT FINDINGS

The field of child abuse pediatrics continues to engender controversy in both medical journals and courtrooms. As scrutiny about the basis for the diagnosis increases, clinicians and researchers work to build a solid base of scientific evidence with thorough and well-designed studies. This is most evident with regards to abusive head trauma, wherein both lay and scientific press challenge the possibility that infants can be severely injured or killed by shaking, blunt force trauma, or both.

SUMMARY

Child abuse pediatrics is a well-established and credible medical field. Although child physical and sexual abuse are age-old problems, public acknowledgement and intervention models are relatively new, and medical literature continues to reflect an increasing and deeper understanding of the impact of abuse throughout the world.