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4 août 2004

Pitfalls in the diagnosis of child sexual abuse by P. Chariot, C. Rey, and P. Werson

Journal of Clinical Forensic Medicine
Volume 6, Issue 1, March 1999, Pages 35-38
Short report
P. Chariot MD
ab C. Rey ca and P. Werson a
a Forensic Medicine Unit, Centre Hospitalier Louise Michel, 91014, Evry, France
b Department of Pathology, Hôpital Henri Mondor, 94000, Créteil, France
c Adolescent Medicine, Department of Pediatry, Hôpital Bicêtre, 94270, Kremlin Bicêtre, France
Available online 4 August 2004.


Case 1: nurses in charge of a 6-year-old girl in a holiday camp noticed some blood spots on the girl's underwear. The possibility of sexual abuse was considered and the girl alleged that her father was responsible. The father was arrested. A surgeon was asked to examine the girl and planned to do it under general anesthaesia. Meanwhile, the girl was brought to the Forensic Medicine Unit. We found a normal hymen and no detectable anal lesions. The girl complained of dysuria and pollakiuria. Urinalysis revealed the presence of blood, leukocytes, and nitrite. Antibiotic treatment for lower urinary tract infection was initiated and all symptoms improved rapidly. The father was released.

Case 2: a 7-year-old boy complained of having been sexually assaulted 24 h before. The boy did not report any pain or bleeding during or after the assault. Examination of the perianal region and of the anal sphineter were normal. Proctoscopy did not show any evidence of trauma to the anal canal. Tests to detect spermatozoa in the rectum were positive. The assailant was arrested.

The present cases illustrate that: (i) psychological and social consequences of the biased interpretation of common symptoms may be dramatic in the case of child sexual abuse; (ii) both questioning and examining a child may be difficult for non-specialized practitioners; and (iii) tests to detect spermatozoa should be systematically performed in the case of a suspected or alleged recent assault, even in the absence of any clinical lesions.

About the reference, clic on the Dr. Philippe Werson picture

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2 commentaires:

  1. The Let Go...Let Peace Come In Foundation is a newly formed nonprofit with a mission to help heal and support adult survivors of childhood sexual abuse worldwide. We are actively seeking adult survivors who would be willing to post a childhood photo and caption, their story, or their creative expressions to our website www.letgoletpeacecomein.org. By uniting survivors from across the globe we can help provide a stronger and more powerful voice to those survivors who have not yet found the courage to speak out. We also have a prepared a youtube video that can be viewed at http://www.youtube.com/watch?v=b4PDC03Gl2k. Together we can; together we should; together we NEED to stand up and be counted. Please visit our site for more details on how you can send us your submissions.

    Thank you for everything you do!

    Gretchen Paules
    Administrative Director
    Let Go...Let Peace Come In Foundation
    630 W. Germantown Pike, Suite 180
    Plymouth Meeting, PA 19462

  2. Thank you for this comment. And Thank you to you for everything you do!