The missing "Bratz" doll: a case of vaginal foreign body

Intravaginal Foreign Body: A Rare Cause of Persistent Vaginal Discharge in a Child

ABSTRACT

Vaginal discharge is a common gynaecologic complaint in pre-menarchal girls. However, an intravaginal foreign body (FB) must be suspected when it is persistent. We report the case of a referred 4-year-old girl with a 5-month history of persistent foul-smelling vaginal discharge. Clinical examination confirmed purulent vaginal discharge, along with a vaginal granuloma. A hard, intravaginal object was felt through the anterior rectal wall on digital rectal examination. A plain pelvic X-ray revealed a radiopaque object whose intravaginal position was confirmed by ultrasonography. The patient underwent granuloma excision plus FB removal and antibiotic treatment. The 12-month follow-up was unremarkable.

Toy-related injuries among children treated in US Emergency Departments, 1990-2011

This study investigates the epidemiology of injuries associated with toys among US children by analyzing data from the National Electronic Injury Surveillance System. During 1990-2011, an estimated 3278073 (95% confidence interval = 2762281-3793865) children <18 years old were treated in US emergency departments for toy-related injuries, averaging 149003 cases annually. The annual injury rate per 10000 children increased significantly by 39.9% from 18.88 in 1990 to 26.42 in 2011. The number and rate of injuries peaked at age 2 years; 63.4% of patients were male; and 80.3% of injuries occurred at home. Ride-on toys accounted for 34.9% of injuries and 42.5% of hospital admissions. This study is the first to comprehensively investigate toy-related injuries among children using a nationally representative data set. The increasing number and rate of toy-related injuries to children, especially those associated with ride-on toys, underscore the need for increased efforts to prevent these injuries.

An unexpected cause of vaginal bleeding: the role of pelvic radiography

Vaginal bleeding and/or discharge in young girls may result from infection, urological problems, endocrine causes, bleeding disorders, dermatological conditions, trauma, sexual abuse, masses or foreign bodies. We report a case of excessive vaginal bleeding caused by a foreign body in a prepubertal girl with emphasis on the diagnostic challenges and pitfalls regarding imaging techniques. In our patient, although invasive and expensive investigations had been initially made, the foreign body was last detected only when a plain pelvic radiography was performed.