Two cases of hymenal scars occurred by child rape

Hymenal transections in children found by photocolposcopy in suspected sexual abuse cases is associated with a history of bleeding

OBJECTIVE

To investigate the difference in selected variables between children with and without hymenal transection, which is a healed defect that extends through the entire depth of the posterior hymenal membrane to the vaginal wall.

MATERIALS AND METHODS

All female children from Southern Denmark who were examined by photocolposcopy in a six-year period were included in a retrospective cohort study. Statistical analyses included a chi-square test and a logistic regression analysis.

RESULTS

Eighty girls under 15 years of age who were suspected to have been sexually abused were included. Sixteen of the girls had hymenal transections. There was a statistically significant correlation between the presence of hymenal transections and reported fresh bleeding after the assault.

CONCLUSION

Bleeding after an assault could indicate more severe lesions, which might explain why these patients did not heal completely.

Forensic medical evaluation of children who present with suspected sexual abuse: How do we know what we know?

The past 40 years have seen significant changes in the way children's genital findings are interpreted in the context of suspected sexual abuse. Many findings previously thought to be diagnostic of sexual abuse are now recognised to be normal variants, caused by other medical conditions or have insufficient specificity to make a definite diagnosis of abuse. Use of the Adams classification in recent years has provided a common language and practical framework for describing and categorising genital findings in children. This review article addresses our current understanding of how to interpret genital findings in children, the evidence on which this interpretation is based, gaps that remain in our knowledge and suggestions for future research.