title: Case Series: Vaginal Rupture Injuries after Sexual Assault in Children and Adolescents.
abstract: BACKGROUND
  Vaginal rupture after sexual assault is a rare but life-threatening occurrence requiring prompt recognition and treatment. Herein, we describe four such cases in children. Our purposes are to increase clinicians' awareness of the physical trauma that a sexual abuse victim can suffer and increase recognition that these victims require immediate trauma services.
  
  
  METHODS
  Each patient had obvious hymenal and vaginal lacerations with a vaginal apical rupture injury and secondary acute blood loss. None of the four victims sustained infectious sequelae.
  
  
  CONCLUSIONS
  Providers should have a low threshold for managing sexual abuse victims as trauma cases when they have obvious hymenal and vaginal lacerations and genital bleeding, proceeding expeditiously to examination using general anesthesia when appropriate.
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri. Electronic address: ireabraham@gmail.com.
authors.forename: Margaret
authors.initials: M
authors.lastname: Abraham
authors.affiliation: Child Abuse Pediatrics, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Jamie
authors.initials: J
authors.lastname: Kondis
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Diane F
authors.initials: DF
authors.lastname: Merritt
mesh_terms: D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D022125:Lacerations; D012421:Rupture; D014621:Vagina / Q000293:injuries*
keywords: Genital injury; Sexual abuse; Vaginal rupture