Genital injuries in girls aged 1-2 years – description of 2 cases = Urazy okolic narządów płciowych u dziewcząt w wieku 1-2 lata – opis 2 przypadków
Genital injuries in girls aged 1-2 years – description of 2 cases

Summary/Abstract: Introduction. Blunt perineal trauma can result from a variety of mechanisms, depending on the child’s development and activity level. The younger the child, the greater the risk that the perineal trauma is related to sexual assault. The problem with young children is obtaining reliable information from them regarding the circumstances of the injury. The younger the child, the more severe the problem. Therefore, this type of injury can pose a challenge in determining the actual mechanism of its occurrence.Case study Case 1. A 16-month-old girl was admitted to the hospital with injuries to the perineum. The examination revealed bruising and abrasions of the epidermis around the vaginal vestibule, and a ruptured mucosa of the posterior commissure. The injuries were said to have occurred when the child was with the caregiver and her partner, including approximately 30 minutes in the presence of the man alone. The man denied touching the child, stating that the injuries were supposed to have occurred accidentally following a fall in the bathroom. The confrontation of the explanations of the caregiver and her partner with the child’s injuries allowed these explanations to be dismissed. Case 2. A 22-month-old girl was admitted to the hospital with a single bruise in the posterior commissure area. The mother suspected that the child may have accidentally sustained a perineum injury while trying to enter or exit a decorative flowerpot. To verify the mother’s explanations, at the request of the expert, the flowerpot in question was inspected and the minor’s behavior was observed when entering and exiting the flowerpot. This allowed the mother’s explanations to be deemed credible.Discussion. In the first case, the presence of multiple injuries (at least 4) located around the entrance to the vagina, characterized by bruising and tears in the mucous membrane, was significant. The number and arrangement of these injuries around the entrance, rather than in a straight line, made the possibility of a fall improbable, particularly given the caregiver’s explanations of the circumstances. The nature of the injuries also clearly contradicted the accounts of the caregiver and her partner. In the second case, despite the location of the injury raising suspicions of a possible sexual assault, the additional data provided above substantiated the mother’s version.

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