Suárez L, Bélanger-Quintana A, Escobar H, de Blas G, Benítez J, Lobo E, de Miguel F, Aparicio J M
Department of Paediatrics, Hospital Ramón y Cajal, Madrid, Spain.
Eur J Pediatr. 2000 Jul;159(7):539-41. doi: 10.1007/s004310051328.
In children, anal abnormalities due to various causes may be confused with sexual abuse. We present the case of a child in whom the suspicion of abuse due to anal dilatation led to the previously unknown diagnosis of myotonic dystrophy. Myopathic involvement of the perianal musculature is a known feature of congenital myotonic dystrophy that usually appears in late childhood or adolescence.
We stress the importance of considering an underlying myopathic condition in the differential diagnosis of anal laxity. Further studies, such as anal ultrasonography, may help when the diagnosis of abuse is not clear.
在儿童中,各种原因导致的肛门异常可能会与性虐待相混淆。我们报告一例儿童病例,因肛门扩张怀疑为虐待,最终却诊断出了此前未知的强直性肌营养不良。肛周肌肉的肌病性受累是先天性强直性肌营养不良的一个已知特征,通常出现在儿童晚期或青春期。
我们强调在肛门松弛的鉴别诊断中考虑潜在肌病状况的重要性。当虐待诊断不明确时,进一步的检查,如肛门超声检查,可能会有所帮助。