We report the case of a 23-month-old female patient who consulted the emergency unit of a tertiary hospital for vaginal bleeding, with a history of previous episode.
There is no history of sexual abuse or genital trauma.
The physical examination showed abundant genital bleeding so they considered within their differential diagnoses: trauma, sexual abuse and child abuse, so the case is reported to the authority, who decide by means of an elite medicolegal examination of management.
During the anamnesis, the forensic physician took all the available information and given the information provided by the mother, which stressed that she did not suspect sexual abuse, she did not suspect vaginal hematoma, she presented genital border with the normal size of the child.
No other lesions were observed.
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The elite group of sexual crime management gave the forensic specialist samples that were taken in the hospital center where the minor was initially assessed, samples that before the findings in the physical examination, the forensic specialist laboratory considered relevant.
In conclusion, the forensic specialist associates the lesion found with genital trauma and describes that it is not possible with the findings to determine whether it is accidental or not.
Associated with the medico-legal examination, the minor is referred to a Children's Hospital with great experience in the management of sexual abuse and child abuse.
The medical staff of this hospital request a new evaluation by another forensic specialist, who comes to the hospital for a new examination.
This examination is performed under sedation, using a magnifying glass during the genital examination, which the lesion described by the first physician was only prolapsed urethral mucosa, simulating a hematoma in the meridian region of the uterus.
The urethral diagnosis was then made.
The minor is taken to surgical management with correction of the stenosis.
