Csorba Roland, Atas Elfrink Zeynep, Tsikouras Panagiotis
Department of Obstetrics and Gynaecology, University of Duisburg-Essen, D-45147 Essen, Germany.
Unit of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrake, GR-68100 Alexandroupolis, Greece.
J Clin Med. 2024 Nov 30;13(23):7297. doi: 10.3390/jcm13237297.
Child sexual abuse (CSA) is a widespread and alarming issue, with an estimated global prevalence of 12-13% (affecting 18% of girls and 8% of boys). Despite its prevalence, many physicians working with children have insufficient knowledge of the medical diagnosis of CSA. This lack of expertise, combined with the sensitive and complex nature of these cases, often hampers proper identification and management. Diagnosing CSA is particularly challenging and requires specialized skills. A majority of children assessed for suspected sexual abuse present with normal genital and anal findings, which complicates the diagnostic process. Barriers such as professional isolation, societal taboos, and the sensitive nature of the subject often result in diagnostic failures. Accurate medical history taking, diagnosis, and documentation of findings are essential for ensuring a precise diagnosis, safeguarding children, and supporting legal proceedings. However, achieving these goals remains elusive without standardized guidelines and adequately trained healthcare professionals. Training of professionals in observing and reporting child sexual abuse is badly needed. This review explores the current state of medical diagnosis in suspected cases of CSA. This article is based on a selective review of pertinent literature retrieved from various databases, including PubMed and the overall index of the Quarterly Update.
儿童性虐待（CSA）是一个普遍且令人担忧的问题，全球估计患病率为12%-13%（影响18%的女孩和8%的男孩）。尽管其普遍存在，但许多从事儿童工作的医生对CSA的医学诊断知识不足。这种专业知识的缺乏，加上这些病例的敏感和复杂性，常常阻碍正确的识别和处理。诊断CSA特别具有挑战性，需要专门技能。大多数接受疑似性虐待评估的儿童生殖器和肛门检查结果正常，这使诊断过程变得复杂。诸如专业孤立、社会禁忌以及该主题的敏感性等障碍常常导致诊断失败。准确的病史采集、诊断和检查结果记录对于确保准确诊断、保护儿童以及支持法律程序至关重要。然而，没有标准化指南和训练有素的医疗专业人员，实现这些目标仍然困难重重。迫切需要对专业人员进行观察和报告儿童性虐待方面的培训。本综述探讨了疑似CSA病例的医学诊断现状。本文基于对从包括PubMed和《季刊更新》总索引在内的各种数据库中检索到的相关文献的选择性综述。
