[Pelvic and genital injuries in children. Sexual injuries of young girls. Management in a medico-legal context].
In the emergency care of a young girl presumed to be a victim of sexual assault and the treatment of the lesions discovered in the perineum and vulvo-vaginal tract, the paediatric surgeon must take into consideration the medico-legal aspects of the file right from the first approach to this young victim. It would actually be damaging to her if a paediatric surgeon reconstituted the perineal tissues, vulva and vagina "ad integrum" without carefully describing the lesions observed and without, whenever possible, taking good quality photographs to be kept in the case file to support the evidence of sexual assault, if a criminal procedure is filed. Similarly, as a complement to this assessment of the initial lesions, the surgeon must be able to establish an anatomical and functional assessment of the vulvo-vaginal tract after healing, to enable the experts appointed by the court to determine the basis for compensation of bodily damages related to the sexual assault and the expenses entailed by further plastic operations required by the sequelae of the genital lesions. The bases for a pretium doloris, future aesthetic, sexual and obstetric damages should also be indicated in any certificate given to the patient's family or to the court experts. Thus, if the surgeon participates indirectly in demonstrating evidence of the crime subject to penal sanction, he can help the victim in her parallel civil court action for compensation of her bodily damages before the repressive jurisdiction.
Soutoul
J H
JH
Expert National Judiciaire, Gynécologue-Accoucheur, Maîtrise de Droit Privé et DEA.
Robert
M
M
Pierre
F
F
D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000331:legislation & jurisprudence; D005260:Female; D005554:Forensic Medicine; D005836:Genitalia, Female / Q000293:injuries*; D006801:Humans; D010388:Pelvis / Q000293:injuries*; D010502:Perineum / Q000293:injuries; D014621:Vagina / Q000293:injuries; D014844:Vulva / Q000293:injuries
Les traumatismes pelviens et génitaux chez l'enfant. Les traumatismes sexuels de la petite fille. Conduite à tenir dans un esprit médico-légal.