II. Precautions

  1. Most cases will be accidental
  2. However observe for signs of pediatric sexual abuse and Nonaccidental Trauma

III. Management: Blunt injury (most cases)

  1. Superficial Skin Tearing or Contusion
    1. Most common site occurs at the fossa between labial majora and labia minora
    2. Local bleeding may occur from site
    3. Perform gentle hygiene with clear water sitz baths multiple times daily for several days
    4. If Dysuria, child may urinate in the sitz bath
  2. Deep Lacerations (esp. involving clitoris, Urethra, labia minora, vaginal introitus, posterior fourchette)
    1. Consider pediatric gynecology or pediatric surgery for better functional and cosmetic closure

IV. Management: Sharp injury (uncommon)

  1. Higher risk for deeper penetrating injury
  2. Consult pediatric gynecology or surgery if signs penetrating injury (esp. blood from introitus)
    1. Urgent vaginal endoscopy may be indicated

V. References

  1. Claudius and Willner in Herbert (2019) EM:Rap 19(1): 2-4

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