A two-year-old girl's mother was concerned that her daughter's vaginal opening appeared to be closed. The mother had noticed this a few months earlier when her daughter had severe diaper rash. The patient did not have urinary problems or vaginal discharge, and her birth and development histories were unremarkable. Genital examination revealed a thin vertical raphe over the site of the vaginal opening see accompanying figure. The labia majora were intact and separated, although only the upper third of the labia minora was identifiable.
Vaginal Foreign Bodies and Child Sexual Abuse: An Important Consideration
Vaginal foreign bodies are a complaint occasionally encountered in pediatric clinics and emergency departments, and when pediatric patients present with a vaginal foreign body sexual abuse may not be considered. We describe two children with vaginal foreign bodies who were found to have been sexually abused. Each child had a discharge positive for a sexually transmitted infection despite no disclosure or allegation of abuse. We recommend that all pre-pubertal girls who present with a vaginal foreign body should be considered as possible victims of sexual abuse and should receive a sexual abuse history and testing for sexually transmitted infections.