II. Precautions
- Most cases will be accidental
- However observe for signs of pediatric sexual abuse and Nonaccidental Trauma
III. Management: Blunt injury (most cases)
- Superficial Skin Tearing or Contusion
- Most common site occurs at the fossa between labial majora and labia minora
- Local bleeding may occur from site
- Perform gentle hygiene with clear water sitz baths multiple times daily for several days
- If Dysuria, child may urinate in the sitz bath
- Deep Lacerations (esp. involving clitoris, Urethra, labia minora, vaginal introitus, posterior fourchette)
- Consider pediatric gynecology or pediatric surgery for better functional and cosmetic closure
IV. Management: Sharp injury (uncommon)
- Higher risk for deeper penetrating injury
- Consult pediatric gynecology or surgery if signs penetrating injury (esp. blood from introitus)
- Urgent vaginal endoscopy may be indicated
V. References
- Claudius and Willner in Herbert (2019) EM:Rap 19(1): 2-4