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The timing of medical examination following an allegation of sexual abuse: is this an emergency?
Arch Dis Child. 2008 Oct; 93(10):851-6.AD

Abstract

AIM

To ascertain the frequency of significant anogenital signs, at medical examination, following an allegation of sexual abuse, in relation to the timing of the examination.

METHOD

A case series of 331 children, who were referred by the police or social services for examination, following an allegation of child sexual abuse or suspicion of this, over a 3(1/2)-year period in a defined geographical area.

RESULTS

Two hundred and fifty-seven children alleged penetrative abuse, of whom 114 were seen within 7 days of the abuse. Twenty-three children alleged penetrative anal abuse within the previous 7 days; 13 of these had abnormal findings (56.5%) compared with 9 (18%) of the 50 children seen more than 7 days after anal abuse. Ninety-two girls alleged penetrative vaginal abuse within the previous 7 days and of these 46 (50%) had abnormal findings, compared with 31 (30.7%) of the 101 girls seen more than 7 days after the alleged abuse. In addition 33 girls seen within 7 days had other signs associated with probable assault. Abnormal findings were more common in post-pubertal girls.

CONCLUSION

Pubertal and post-pubertal girls are more likely to have significant genital signs if they are examined within 7 days of the last episode of sexual abuse. Our findings suggest that abnormal anal signs are more likely to be present in the acute phase. This study indicates that children should be examined as soon as possible following a referral. This will have implications for clinical practice. Regardless of the lack of accurate history it will always be important to examine the child as soon as possible after disclosure.

Authors+Show Affiliations

Department of Child Health, Swansea NHS Trust, Swansea, UK.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18456688

Citation

Watkeys, J M., et al. "The Timing of Medical Examination Following an Allegation of Sexual Abuse: Is This an Emergency?" Archives of Disease in Childhood, vol. 93, no. 10, 2008, pp. 851-6.
Watkeys JM, Price LD, Upton PM, et al. The timing of medical examination following an allegation of sexual abuse: is this an emergency? Arch Dis Child. 2008;93(10):851-6.
Watkeys, J. M., Price, L. D., Upton, P. M., & Maddocks, A. (2008). The timing of medical examination following an allegation of sexual abuse: is this an emergency? Archives of Disease in Childhood, 93(10), 851-6. https://doi.org/10.1136/adc.2007.123604
Watkeys JM, et al. The Timing of Medical Examination Following an Allegation of Sexual Abuse: Is This an Emergency. Arch Dis Child. 2008;93(10):851-6. PubMed PMID: 18456688.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The timing of medical examination following an allegation of sexual abuse: is this an emergency? AU - Watkeys,J M, AU - Price,L D, AU - Upton,P M, AU - Maddocks,A, Y1 - 2008/05/02/ PY - 2008/5/6/pubmed PY - 2008/10/17/medline PY - 2008/5/6/entrez SP - 851 EP - 6 JF - Archives of disease in childhood JO - Arch. Dis. Child. VL - 93 IS - 10 N2 - AIM: To ascertain the frequency of significant anogenital signs, at medical examination, following an allegation of sexual abuse, in relation to the timing of the examination. METHOD: A case series of 331 children, who were referred by the police or social services for examination, following an allegation of child sexual abuse or suspicion of this, over a 3(1/2)-year period in a defined geographical area. RESULTS: Two hundred and fifty-seven children alleged penetrative abuse, of whom 114 were seen within 7 days of the abuse. Twenty-three children alleged penetrative anal abuse within the previous 7 days; 13 of these had abnormal findings (56.5%) compared with 9 (18%) of the 50 children seen more than 7 days after anal abuse. Ninety-two girls alleged penetrative vaginal abuse within the previous 7 days and of these 46 (50%) had abnormal findings, compared with 31 (30.7%) of the 101 girls seen more than 7 days after the alleged abuse. In addition 33 girls seen within 7 days had other signs associated with probable assault. Abnormal findings were more common in post-pubertal girls. CONCLUSION: Pubertal and post-pubertal girls are more likely to have significant genital signs if they are examined within 7 days of the last episode of sexual abuse. Our findings suggest that abnormal anal signs are more likely to be present in the acute phase. This study indicates that children should be examined as soon as possible following a referral. This will have implications for clinical practice. Regardless of the lack of accurate history it will always be important to examine the child as soon as possible after disclosure. SN - 1468-2044 UR - https://www.unboundmedicine.com/medline/citation/18456688/The_timing_of_medical_examination_following_an_allegation_of_sexual_abuse:_is_this_an_emergency L2 - http://adc.bmj.com/cgi/pmidlookup?view=long&pmid=18456688 DB - PRIME DP - Unbound Medicine ER -