ERIC Number: EJ915606
Record Type: Journal
Publication Date: 2011-Jan
Abstractor: As Provided
Reference Count: 0
Vaginal Lacerations from Consensual Intercourse in Adolescents
Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.
Child Abuse & Neglect: The International Journal, v35 n1 p69-73 Jan 2011
Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. Methods: We present a case series of 4 female adolescent patients seen at a children's hospital over a period of 6 months. Each patient developed significant vaginal bleeding after sexual intercourse, and 3 of the patients presented to the emergency department with vital signs consistent with compensated shock. Results: Each patient was evaluated by pediatric surgery, and found to have a laceration of the vagina. Three of the patients described consensual intercourse prior to the onset of bleeding, and had lacerations of the vaginal fornices; these patients were determined to have injuries resulting from consensual sexual intercourse. The fourth patient reported sexual assault as the cause of her injuries, and was treated for longitudinal lacerations of the vaginal wall. Conclusions: Lacerations of the upper vagina are not frequently reported in forced vaginal intercourse, but are occasionally reported as injuries sustained during consensual coitus. In the absence of reported sexual assault, a severe vaginal fornix laceration is consistent with the diagnosis of coital injury from consensual intercourse. Diagnosis and treatment of this injury can be delayed due to the sensitive nature of these injuries. Bleeding can be profuse, leading to hemorrhagic shock, and these injuries may require transfusion of blood products and surgical repair in some cases. Complications may include hemoperitoneum, pneumoperitoneum, or retroperitoneal hematoma, even in the absence of complete vaginal perforation. Practice implications: Knowledge of the consensual sexual injuries that may occur in adolescent patients can guide diagnosis, treatment, and counseling for the patient and her family, preventing long-term medical complications and legal consequences.
Descriptors: Sexual Abuse, Injuries, Surgery, Identification, Adolescents, Patients, Human Body, Hospitals, Pediatrics, Prevention, Clinical Diagnosis, Medical Services, Counseling, Legal Problems, Sexuality
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Authoring Institution: N/A