McCann J, Voris J, Simon M
Department of Pediatrics, Valley Medical Center, Fresno, Calif.
Am J Dis Child. 1988 Jun;142(6):659-63. doi: 10.1001/archpedi.1988.02150060093040.
Six cases involving six sisters, all of whom were sexually molested, are presented to illustrate the association between labial adhesions and posterior fourchette injuries in sexually abused children. Although labial adhesions are a relatively common lesion, they only recently have been associated with childhood sexual abuse. Labial adhesions are ordinarily found in girls between 2 months and 7 years of age and are usually very superficial and disappear spontaneously by the time the child approaches puberty. We encountered six sisters, all of whom had been sexually abused, who had labial adhesions. Four of the six had changes in the area of the posterior fourchette that were consistent with previous trauma. In addition, four of the girls' hymens had thickened, irregular edges or other changes that were considered abnormal. The father, the grandfather, and an uncle confessed to lewd and lascivious misconduct with the children. Although labial adhesions alone are not reason enough to make a report of sexual abuse, the physician is obligated to inquire as to the possible cause if the adhesions do not fit the usual pattern or if there are other suspicious findings.
本文呈现了6例涉及6名姐妹的案例，她们均遭受过性侵犯，以说明性虐待儿童中阴唇粘连与后阴唇系带损伤之间的关联。虽然阴唇粘连是一种相对常见的病症，但直到最近才将其与儿童期性虐待联系起来。阴唇粘连通常见于2个月至7岁的女童，通常非常表浅，在儿童接近青春期时会自行消失。我们遇到了6名均遭受过性虐待且患有阴唇粘连的姐妹。其中6人中有4人后阴唇系带区域有与既往创伤相符的变化。此外，这些女孩中有4人的处女膜边缘增厚、不规则或有其他被认为异常的变化。父亲、祖父和一名叔叔承认对这些儿童有猥亵和淫荡的不当行为。虽然仅阴唇粘连不足以构成报告性虐待的充分理由，但如果粘连不符合通常模式或有其他可疑发现，医生有义务询问可能的病因。
