Delayed repair for complex genital trauma following sexual assault in a 3-year-old female with late presentation for care: a case report

Abstract Background Genital trauma following child sexual abuse presents a complex and variable clinical picture of pelvic perineal injury, necessitating a comprehensive understanding of the structures involved in effective management. Ideally, these cases are considered urgent, and primary repair s...

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Main Authors: Raha Maroyi, Denis Mukwege, Lisa Doble, Robert Andrianne
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-025-05288-x
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author Raha Maroyi
Denis Mukwege
Lisa Doble
Robert Andrianne
author_facet Raha Maroyi
Denis Mukwege
Lisa Doble
Robert Andrianne
author_sort Raha Maroyi
collection DOAJ
description Abstract Background Genital trauma following child sexual abuse presents a complex and variable clinical picture of pelvic perineal injury, necessitating a comprehensive understanding of the structures involved in effective management. Ideally, these cases are considered urgent, and primary repair should be performed as an emergency. Unfortunately, the window of opportunity for urgent action may be missed as the patient may not present for care until much later. Case presentation We report the case of a 3-year-old African (Congolese) girl who presented to the Panzi Hospital’s sexual violence ward in Bukavu, Democratic Republic of the Congo (DRC), 3 days after being sexually abused by an adult family friend. Clinical examination revealed a complex perineal tear with a split in the posterior vaginal wall extending to the posterior vaginal cul-de-sac and a fourth-degree rectal prolapse. A cleft was also noted in the external orifice of the urethral meatus. All the lesions were infected and covered with fibrin, with no signs of peritonitis. Initial management included admission for locoregional treatment with antiseptic solution and sitz baths. A total of 2 weeks later, surgical intervention was performed, which resulted in improved short- and long-term outcomes in terms of the vulvar cosmetic, functional, and psychological aspects. Conclusion In cases of delayed access to medical care for several days for complex genital trauma following child sexual abuse, treatment of the infection and delayed closure lead to better outcomes.
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spelling doaj-art-8c4d9d8d0e6f4ab0829191aecc2d44e22025-08-20T03:43:21ZengBMCJournal of Medical Case Reports1752-19472025-07-011911610.1186/s13256-025-05288-xDelayed repair for complex genital trauma following sexual assault in a 3-year-old female with late presentation for care: a case reportRaha Maroyi0Denis Mukwege1Lisa Doble2Robert Andrianne3Panzi General Referral HospitalPanzi General Referral HospitalTownsville University HospitalUrology Department, University Hospital of LiègeAbstract Background Genital trauma following child sexual abuse presents a complex and variable clinical picture of pelvic perineal injury, necessitating a comprehensive understanding of the structures involved in effective management. Ideally, these cases are considered urgent, and primary repair should be performed as an emergency. Unfortunately, the window of opportunity for urgent action may be missed as the patient may not present for care until much later. Case presentation We report the case of a 3-year-old African (Congolese) girl who presented to the Panzi Hospital’s sexual violence ward in Bukavu, Democratic Republic of the Congo (DRC), 3 days after being sexually abused by an adult family friend. Clinical examination revealed a complex perineal tear with a split in the posterior vaginal wall extending to the posterior vaginal cul-de-sac and a fourth-degree rectal prolapse. A cleft was also noted in the external orifice of the urethral meatus. All the lesions were infected and covered with fibrin, with no signs of peritonitis. Initial management included admission for locoregional treatment with antiseptic solution and sitz baths. A total of 2 weeks later, surgical intervention was performed, which resulted in improved short- and long-term outcomes in terms of the vulvar cosmetic, functional, and psychological aspects. Conclusion In cases of delayed access to medical care for several days for complex genital trauma following child sexual abuse, treatment of the infection and delayed closure lead to better outcomes.https://doi.org/10.1186/s13256-025-05288-xChild sexual abuseChild sexual assaultExamination under anesthesiaPerineal injuriesPerineal traumaSurgery
spellingShingle Raha Maroyi
Denis Mukwege
Lisa Doble
Robert Andrianne
Delayed repair for complex genital trauma following sexual assault in a 3-year-old female with late presentation for care: a case report
Journal of Medical Case Reports
Child sexual abuse
Child sexual assault
Examination under anesthesia
Perineal injuries
Perineal trauma
Surgery
title Delayed repair for complex genital trauma following sexual assault in a 3-year-old female with late presentation for care: a case report
title_full Delayed repair for complex genital trauma following sexual assault in a 3-year-old female with late presentation for care: a case report
title_fullStr Delayed repair for complex genital trauma following sexual assault in a 3-year-old female with late presentation for care: a case report
title_full_unstemmed Delayed repair for complex genital trauma following sexual assault in a 3-year-old female with late presentation for care: a case report
title_short Delayed repair for complex genital trauma following sexual assault in a 3-year-old female with late presentation for care: a case report
title_sort delayed repair for complex genital trauma following sexual assault in a 3 year old female with late presentation for care a case report
topic Child sexual abuse
Child sexual assault
Examination under anesthesia
Perineal injuries
Perineal trauma
Surgery
url https://doi.org/10.1186/s13256-025-05288-x
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AT lisadoble delayedrepairforcomplexgenitaltraumafollowingsexualassaultina3yearoldfemalewithlatepresentationforcareacasereport
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