Child Sexual Abuse in Emergency Medicine Follow-up

Updated: Nov 12, 2015
  • Author: Ann S Botash, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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Follow-up

Further Outpatient Care

Most sexually abused children should be referred for mental health counseling.

Follow up for medical problems (eg, genitourinary complaints) should be arranged with the child's primary care physician.

If the community has a child abuse referral center, the children should be referred there for follow-up care according to local protocol.

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Further Inpatient Care

Inpatient care is recommended if the child's safety is in jeopardy or if the child has an acute traumatic injury requiring inpatient treatment.

Occasionally, treatment for a STD requires hospital admission and inpatient treatment.

Severe mental or emotional trauma may necessitate inpatient admission and care.

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Inpatient & Outpatient Medications

Prophylactic antibiotics in prepubertal sexually abused children are indicated in rare cases.

Prophylactic antibiotics may be given to pubertal sexually abused children after an acute assault.

Use of postassault pregnancy prevention options should be discussed with the pubertal sexual assault victim.

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Complications

Complications of sexual abuse may include infection and psychological/social problems.

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Prognosis

Sexually abused children have significantly higher occurrences of the following:

  • Eating disorders
  • Suicidal behaviors
  • Self-injury
  • Psychosis [23]

Children who are sexually abused may be at increased risk of reabuse.

Ongoing emotional/psychological problems may be indicative of abused children's false beliefs about themselves and the sexual abuse experience.

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Patient Education

Families are usually concerned about injury in the child. Reassurance may involve an explanation that children can be sexually abused and have no physical findings to support their allegations.

For excellent patient education resources, visit eMedicineHealth's Children's Health Center. Also, see eMedicineHealth's patient education articles Child Abuse and Sexual Assault and Abuse.

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