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J Indian Assoc Pediatr Surg. 2013 Jul;18(3):105-11. doi: 10.4103/0971-9261.116043.

Management of child victims of acute sexual assault: Surgical repair and beyond.

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Department of Pediatric Surgery, Byramjee Jeejeebhoy Medical College, Pune, Maharashtra, India.



To evaluate the outcome of definitive repair of anogenital injuries (AGI) in child victims of acute sexual assault.


It is a prospective study of emergency care provided to child victims of acute sexual assault at a tertiary care Pediatric Surgical Unit in Maharashtra, India.


Out of 25 children, who presented during January 2009-December 2010 with suspected sexual assault, five children (one male and four female, between 4-9 years of age), had incurred major AGI. These children underwent definitive repair and a diverting colostomy. Perineal pull-through was performed in the male child with major avulsion of rectum. One 4-year-old girl with intraperitoneal vaginal injury required exploratory laparotomy in addition.


The postoperative period and follow-up was uneventful in all our patients. Four out of five patients have excellent cosmetic and functional outcome with a follow-up of 2-4 years. Our continence results are 100%.


Children with acute sexual assault need emergency care. To optimally restore the distorted anatomy, all major AGI in such children should be primarily repaired by an expert, conversant with a child's local genital and perineal anatomy. Along with provision of comprehensive and compassionate medical care, prevention of secondary injuries should be the ultimate goal.


Anogenital injuries; acute sexual assault; child abuse; definitive surgical repair; emergency management

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