title: Pediatric male rectal and genital trauma: accidental and nonaccidental injuries.
abstract: OBJECTIVE
  To characterize accidental pediatric rectal/genital trauma in males and compare these physical findings to a cohort of boys evaluated for sexual abuse.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary pediatric trauma center/sexual abuse clinic.
  
  
  METHODS
  Male patients evaluated in the emergency department for rectal/genital trauma from 9/1/89 through 10/31/93 ("accidental group"). Male patients referred to Child Protection Services for suspected sexual abuse from 1/1/93 through 12/31/95 who had abnormal genital physical findings ("sexual abuse group").
  
  
  METHODS
  Outcomes measured included age, mechanism of injury, category of diagnosis, location of injury, and type of injury.
  
  
  RESULTS
  Forty-four male patients comprised the accidental group, aged six months to 17 years. The most common mechanism was a fall onto an object (34%). The most common injuries were lacerations/perforations of the scrotum (36%) followed by penile lacerations/perforations (25%). No patient had an isolated rectal laceration. Forty-four male patients with positive physical findings comprised the sexual abuse group. Ages ranged from seven months to 18 years. All patients had rectal lesions. Penile lacerations/perforations were the only other injuries documented, occurring in two patients.
  
  
  CONCLUSIONS
  Accidental rectal/genital trauma in the pediatric population is uncommon; scrotal trauma occurs much more frequently than rectal trauma. Rectal/genital injury in the sexual abuse group typically involves only the rectal area. Sexual assault should be considered in patients with isolated rectal injury or whenever the alleged history does not correlate with physical findings.
authors.affiliation: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
authors.forename: H A
authors.initials: HA
authors.lastname: Kadish
authors.forename: J E
authors.initials: JE
authors.lastname: Schunk
authors.forename: H
authors.initials: H
authors.lastname: Britton
mesh_terms: D000059:Accidents; D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005837:Genitalia, Male / Q000293:injuries*; D006801:Humans; D007223:Infant; D008297:Male; D012007:Rectum / Q000293:injuries* / Q000473:pathology; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000175:diagnosis / Q000209:etiology / Q000473:pathology