Pou Fernández J, Jordán García I, Gómez López L
Unitat Integrada de Pediatria, Hospital Clínic-Hospital Sant Joan de Déu, Universitat de Barcelona.
An Esp Pediatr. 1996 Sep;45(3):245-8.
We have analyzed our population in regards to child sexual abuse during 1994 and propose a diagnostic classification of our findings.
We reviewed retrospectively 18 cases of abuse, collection in each case the following data: age, sex, reason for the consultation, family situation, perpetrator, positive clinical history or not, physical findings, psychological disorders and complementary examinations. We established 4 classification levels: normal, compatible with abuse, suspicious and sexual contact or certain penetration.
The number of children attended was 18. Thirteen (72%) were female. The youngest was 1 month old and the oldest 14.5 years. The clinical history was positive in 6 cases. The physical findings allowed a certain diagnostic in 3 cases. Presence of semen was demonstrated in 1 case and 1 positive culture for gonococci was obtained. The final diagnosis was normal in 6 cases, compatible with abuse in 4, suspicious in 3 and certain sexual contact or penetration in 5.
The diagnosis of sexual abuse is very difficult. The clinical history is still necessary due to the fact that physical findings and complementary tests tend to not be conclusive. We propose that once the information has been evaluated the conclusion be classified into 4 groups: normal, compatible with abuse, suspicious and certain sexual contact or penetration.
我们分析了1994年期间遭受儿童性虐待的人群情况,并对我们的研究结果提出了一种诊断分类方法。
我们回顾性研究了18例虐待病例,收集了每个病例的以下数据:年龄、性别、就诊原因、家庭情况、施虐者、临床病史是否阳性、体格检查结果、心理障碍及辅助检查。我们设定了4个分类级别:正常、与虐待相符、可疑以及有性接触或确定有性侵。
就诊儿童数量为18名。其中13名(72%)为女性。年龄最小的1个月,最大的14.5岁。6例临床病史呈阳性。体格检查结果在3例中得出了明确诊断。1例检测到精液,1例获得淋球菌阳性培养结果。最终诊断为正常的有6例,与虐待相符的有4例,可疑的有3例,确定有性接触或性侵的有5例。
性虐待的诊断非常困难。由于体格检查结果和辅助检查往往无法得出定论,临床病史仍然是必要的。我们建议,一旦对信息进行评估,应将结论分为4组:正常、与虐待相符、可疑以及确定有性接触或性侵。