Examen et conduite à tenir chez un jeune enfant victime d'abus sexuels

How Do We Recognize Recent Sexual Abuse in Children Less than 10 Years of Age? What Is the Role of Paediatric Wards? Experience in a French Paediatric Hospital

“…The use of a catheter with balloon inflation for a better visualization of the hymen is unnecessary and traumatic at this age. Instrumental help requires expertise [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], and should be reserved for pubescent patients [20].…”

“…Between three and 15 days after the abuse, the examination must be made quickly. Beyond 15 days, the examination may be delayed [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. In practice, it is recommended that this review include apart from genital and anal examinations "a complete physical examination with emphasis on growth parameters and sexual development of children examined mucocutaneous rigorous, searching for traces of violence throughout the body and especially at the inner thighs and chest, as well as areas of support and restraint (neck, wrists, ankles) a review of the oral cavity in search of lesions dental and mucous membranes, as well as the tongue-an observation of child behavior during clinical examination" [1].…”

“…There is no need to touch and it should be painless. The examiner should have precise notions about normal anatomical variations [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] as the large variations of aspects of the hymen before puberty to avoid errors [22].…”

“…Non-sexual transmission has been demonstrated beyond this period by other authors [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”

“…The review cannot be limited to the technical expertise of forensic aspects. The pediatric home team must be competent to collect details of history, examine the child, make a differential diagnosis with other causes of behavioral or clinical features, request additional tests, and send the certificates to ensure the appropriate care of the children [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”