Genital Trauma of Female Children in Zawia Teaching Hospital

Abstract

Genital trauma of female children may occur as a result of multiple injuries (as in motor vehicle accident) or an isolated
injury including liquid injection, burns, penetrating injury, and sexual insult. Some children are victim of sexual insult or
abuse either isolated or repeated and some incident is accident that never occur again. In case of genital trauma thoughtful
approach is necessary to be supportive to the children and their parents. In some societies the family denied history
of sexual insult due to some social factors which include concern about virginity and rejection of female from society
(refused to be married), a clinician needs to assess whether the history provider is compatible with the injuries found in
genital examination, inconsistencies between the history and physical examination should arouse suspicious of sexual
assault or abuse.
The study aimed to describe the etiology of genital trauma of female children and to demonstrate that one of the commonest
causes of trauma is sexual insult.
Prospective study of 50 cases of female children with genital trauma admitted in Gynecological department of Zawia
teaching hospital. History of trauma was taken from the children or their parent or from the witness of the accident.
The total number of cases included in this study was 50 patients with genital trauma and their mean age is 6 years; one of
them is psychologically disturbed. In all cases history was taken from the children and their families and from witness
of the accident. In 75% of cases of sexual insult the family denied the history due to social factors. 84% of the cases had
minor genital trauma and 16% with major trauma, this study showed that 10% of the cases the hymen was ruptured and in
6% the vagina was injured in this series. 40% of the genital injuries were due to sexual insult, 34% due to straddle injury,
10% as sharp instrument and 6% as penetrating injury. 40% of the patients need exploration under anesthesia and 20%
of them needed repair.
In cases of genital trauma of female children sexual insult needs to be taken into consideration, therefore, careful and
extended history should be taken and social and psychological counseling may be needed for the patients and their
families. A statement should be made to recognize the magnitude of the problem and act to prevent it.