eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics
Child Abuse & Neglect, Sexual Abuse: Multimedia
Updated: Dec 11, 2008
Multimedia
 | Media file 1: Infant girl in frog-leg supine position. Genital examination reveals translucent hymenal membrane with significant redundant tissue making hymenal orifice difficult to appreciate in this photo. With further traction applied to both labia majora, the hymenal orifice could be observed. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 2: Infant girl in frog-leg supine position. Hymenal orifice is crescentic (little time is present at 12-o'clock posterior). Hymen is thin and translucent with vessels visible. Hymenal edge is regular and without interruption. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 3: Girl in knee-chest position. Hymenal orifice is crescentic, thin, translucent, and without interruption or scarring. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 4: Infant girl in frog-leg supine position. Hymenal orifice is annular, with tissue present around entire opening. Some redundancy is present. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 5: Infant girl in frog-leg supine position. Hymenal orifice is annular with a "bump" at 1-o'clock position and a small "notch" at 10-o'clock position. Hymenal membrane is thin and translucent, with no interruption or scarring. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 6: Girl in frog-leg supine position, exhibiting annular hymenal orifice. Tissue is thin and translucent without disruption or scarring. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 7: Girl in frog-leg supine position exhibiting hymenal orifice, which is crescentic and has symmetric attenuation at lateral margins. No scarring is present. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 8: Girl in frog-leg supine position exhibiting hymen. Hymen is septate; a band of tissue crosses the hymenal orifice. Tissue is thin with no scarring present. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 9: Adolescent girl in supine position demonstrating estrogenized tissue. Hymen is thicker, pink, and fairly opaque with no vessels visible. Tissue is redundant. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 10: Genital examination of adolescent girl revealing estrogenized hymenal tissue that is pink, thick, and opaque. Orifice appears irregular, secondary to significant redundancy of tissue. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 11: Genital examination of adolescent girl demonstrating estrogenized hymenal tissue that is pink, thick, and opaque. Orifice is irregular due to areas of redundancy, especially at the 9-o'clock position. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 12: Prepubertal girl with foul-smelling bloody discharge. On examination, a foreign body in the vagina was found just past the hymenal orifice. The foreign body is lodged in vagina and appears to be toilet tissue that is colonized with bacteria, causing a vulvovaginitis. The foreign body was dislodged with gentle water flushing during examination. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 13: Genital examination of prepubertal girl with foul-smelling bloody discharge. On examination, a foreign body in the vagina was found lodged just past the hymenal orifice and appears to be toilet tissue that is colonized with bacteria, causing a vulvovaginitis. The foreign body was dislodged with gentle water flushing during examination. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 14: Infant girl with imperforate hymen and absence of a hymenal orifice. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 15: Genital examination of girl revealing bruising on medial aspects of labia minora, hymenal trauma with disruption of hymenal tissue, and fresh blood. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 16: Infant girl with significant bruising that involved labia minora and labia majora, hymenal trauma with disruption of hymen, and fresh blood. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 17: Genital examination 10 days after infant girl presented with significant bruising that involved labia minora and labia majora, hymenal trauma with disruption of hymen, and fresh blood. Bruising on vulvar structure is nearly resolved. Hymen is healing and no blood is observed. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 18: Genital examination of girl in frog-leg supine position after genital trauma. Examination reveals suture in place at 6-o'clock position to stop bleeding from injury. Hymenal edge is irregular and asymmetric. Photo courtesy of Carol D. Berkowitz, MD. |
 | Media file 19: US child maltreatment trends. |
 | Media file 20: Possible factors influencing the decline in substantiated cases of child sexual abuse. |
 | Media file 21: Adverse Childhood Experience (ACE) Pyramid. |
More on Child Abuse & Neglect, Sexual Abuse |
| Overview: Child Abuse & Neglect, Sexual Abuse |
| Differential Diagnoses & Workup: Child Abuse & Neglect, Sexual Abuse |
| Treatment & Medication: Child Abuse & Neglect, Sexual Abuse |
| Follow-up: Child Abuse & Neglect, Sexual Abuse |
 Multimedia: Child Abuse & Neglect, Sexual Abuse |
| References |
| « Previous Page |
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Further Reading
Keywords
child sexual abuse, sexual abuse, sexual misuse, sexual maltreatment, sexual child abuse, molestation, sexual molestation, intrafamilial sexual abuse, incest, assault, sexual assault, rape, inappropriate observation, inappropriate touching, sexualized kissing, fondling, masturbation, penetration of the vagina, oral-genital, genital-genital, anal-genital, sexualized behaviors, phobias, sleep disturbances, changes in appetite, change in or poor school performance, regression to an earlier developmental level, running away, truancy, aggressiveness, acting out behaviors
social withdrawal, sadness, depression, genital bleeding, lichen sclerosis, dermatitis, sexually transmitted diseases, STDs, vaginal discharge, Staphylococcus aureus, Haemophilus influenzae, Mycoplasma species, anogenital bruising, Crohn disease, Kawasaki syndrome, Stevens-Johnson syndrome, eating disorders, anxiety disorders, substance abuse, somatization, posttraumatic stress disorder, PTSD, dissociative disorders, irritable bowel syndrome, dyspepsia, chronic abdominal pain, ischemic heart disease, cancer, stroke, chronic bronchitis, emphysema, diabetes, hepatitis, skeletal fractures
