青春期前女童出现阴道出血。
Prepubertal girl with vaginal bleeding.
作者信息
Kondamudi Noah P, Gupta Ayush, Watkins Amina, Bertolotti Amy
机构信息
Division of Pediatric Emergency Medicine, Department of Pediatrics, Rutgers New Jersey Medical School, Newark, New Jersey.
Department of Pediatrics, The Brooklyn Hospital Center, Brooklyn, New York.
出版信息
J Emerg Med. 2014 Jun;46(6):769-71. doi: 10.1016/j.jemermed.2013.11.075. Epub 2014 Feb 2.
BACKGROUND
Prepubertal children with vaginal bleeding are frequently brought in to the Emergency Department (ED) for evaluation with the primary concern of sexual abuse. Appropriate history and physical examination can help recognize the specific cause and allay anxiety of parents and reduce unnecessary work-up.
OBJECTIVE
The purpose of this report is to describe a frequently unrecognized cause of vaginal bleeding that is unrelated to sexual abuse.
CASE REPORT
We report the case of a 6-year-old African-American girl referred to our ED as a case of vaginal bleeding with suspicion of sexual abuse. She was clinically diagnosed to have urethral prolapse.
CONCLUSION
In prepubertal girls with vaginal bleeding, urethral prolapse should be strongly considered as a diagnostic possibility. Increased physician awareness and early recognition of urethral prolapse avoids unnecessary examinations and patient anxiety and prevents misdiagnosis as sexual abuse.
背景
青春期前出现阴道出血的儿童常因性虐待这一首要担忧因素而被送往急诊科（ED）进行评估。恰当的病史询问和体格检查有助于识别具体病因，减轻家长的焦虑，并减少不必要的检查。
目的
本报告旨在描述一种常未被识别的与性虐待无关的阴道出血病因。
病例报告
我们报告一例6岁非裔美国女孩，因阴道出血被转诊至我院急诊科，怀疑为性虐待。临床诊断为尿道脱垂。
结论
对于青春期前阴道出血的女孩，应高度考虑尿道脱垂这一诊断可能性。提高医生对尿道脱垂的认识并早期识别，可避免不必要的检查和患者焦虑，防止误诊为性虐待。
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