Prepubertal girl with vaginal bleeding.
BACKGROUND
Prepubertal children with vaginal bleeding are frequently brought in to the Emergency Department (ED) for evaluation with the primary concern of sexual abuse. Appropriate history and physical examination can help recognize the specific cause and allay anxiety of parents and reduce unnecessary work-up.


OBJECTIVE
The purpose of this report is to describe a frequently unrecognized cause of vaginal bleeding that is unrelated to sexual abuse.


METHODS
We report the case of a 6-year-old African-American girl referred to our ED as a case of vaginal bleeding with suspicion of sexual abuse. She was clinically diagnosed to have urethral prolapse.


CONCLUSIONS
In prepubertal girls with vaginal bleeding, urethral prolapse should be strongly considered as a diagnostic possibility. Increased physician awareness and early recognition of urethral prolapse avoids unnecessary examinations and patient anxiety and prevents misdiagnosis as sexual abuse.
Division of Pediatric Emergency Medicine, Department of Pediatrics, Rutgers New Jersey Medical School, Newark, New Jersey.
Noah P
NP
Kondamudi
Department of Pediatrics, The Brooklyn Hospital Center, Brooklyn, New York.
Ayush
A
Gupta
Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey.
Amina
A
Watkins
Department of Nursing, University Hospital, Newark, New Jersey.
Amy
A
Bertolotti
D002648:Child; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D011391:Prolapse; D014522:Urethral Diseases / Q000150:complications* / Q000175:diagnosis*; D014592:Uterine Hemorrhage / Q000209:etiology*
prepubertal; sexual abuse; urethral prolapse; vaginal bleeding