Helpfulness of rectoanal endosonography in diagnosis of sexual abuse in a child

Abstract

Background: Clinical importance of sexual abuse in children has rapidly expanded in recent years, but despite of it, the lack of medical signs in the vast majority of sexual abuse cases, makes it difficult to assess. Given that, owing to our prior experience in endosonography (EUS) of the anal canal in child with anorectal malformations, we wanted to test EUS as a diagnostic method of sexual abuse in a child.

Purpose: The purpose of our study is to present our experience in the use of anorectal EUS among children with suspected sexual abuse.

Materials/methods: We present 40 consecutive patients (34 boys and 6 girls, age: 10 months-13 years) recruited from April 2010 to December 2012, with suspected sexual abuse those made a transrectal EUS.

Results: The procedure was well-tolerated in all patients without complications. Rectoanal EUS findings were normal in 27 patients and showed a partial interruption in the external anal sphincter in 8, scars in 2, double rail image in 2, and rectal wall hematoma in 1.

Conclusions: The interpretation of findings in children depends of historical, physical, and laboratory findings. We believe that anal EUS is another aid in the constellation of clinical factors that could help in diagnostic of sexual abuse.