Department of Urology, Medical University of Vienna, Vienna, Austria.
Int J Impot Res. 2021 Mar;33(2):210-216. doi: 10.1038/s41443-020-00353-z. Epub 2020 Sep 17.
The medical approach to children who may have been sexually abused involves several issues and aspects that need to be considered. The medical examination of children with suspected sexual abuse is important, but a detailed medical history from the child and the parents or caretakers is always part of every thorough examination. It can take a long time until victims disclose their abuse and physical signs of abuse may no longer be visible at the time of examination. If the physical examination is performed non-acutely, only 2.2% of sexually abused girls show diagnostic signs of injury. An experienced examiner should ideally perform the examination in suspected sexual abuse of children. Knowledge of the current literature is of importance, as the interpretation of findings has changed over the past decades and it can be difficult to differentiate between normal variants, symptoms of other medical problems, and signs of sexual assault. Furthermore, sexual abuse of children presents in various form, not necessarily leading to physical injuries. Since 1992, Adams et al. publish a regularly updated system for the classification of anogenital findings in children with suspected sexual abuse, including a detailed list of physical findings and infections related to sexual abuse. The purpose of this article is to summarize important aspects of the medical approach to children with suspected sexual abuse according to the current literature.
对可能遭受性虐待的儿童的医学处理涉及需要考虑的几个问题和方面。对疑似性虐待儿童的医学检查很重要，但从儿童及其父母或照顾者那里获得详细的病史始终是每次彻底检查的一部分。受害者可能需要很长时间才会透露他们遭受的虐待，而且在检查时，虐待的身体迹象可能不再可见。如果非急性进行体格检查，只有 2.2%的受虐待女孩显示出损伤的诊断迹象。在儿童疑似性虐待的情况下，理想情况下应由经验丰富的检查者进行检查。了解当前文献很重要，因为过去几十年来，对检查结果的解释已经发生了变化，并且很难区分正常变异、其他医疗问题的症状和性侵犯的迹象。此外，儿童的性虐待表现形式多种多样，不一定导致身体受伤。自 1992 年以来，Adams 等人发布了一个定期更新的系统，用于对疑似性虐待儿童的肛门生殖器发现进行分类，包括与性虐待相关的身体发现和感染的详细清单。本文的目的是根据当前文献总结疑似性虐待儿童的医学处理的重要方面。
