Polyembolokoilamania in Child Sexual Abuse: Physical Examination Findings After Abusive Foreign Body Insertion and Literature Summary.

Abstract

To characterize the physical examination findings in children and adolescents who disclosed insertion of an object into their bodies as part of their sexual abuse history and to identify how this population compares to similar cases described in the published literature. This is a 15-year retrospective review of children younger than 18 years seen at a large urban children's assessment center. In addition, we reviewed and summarized the last two decades of literature characterizing pediatric anogenital foreign bodies to better understand previously described findings in similar populations. Sixty-eight children whose abuse histories included anal or genital insertion of a foreign body still presented with normal examination findings in the vast majority (89.7%) of cases, despite the diversity of items described. The literature on anogenital foreign bodies was sparse, offered a variety of approaches to the overall evaluation of such cases, and demonstrated inconsistent consideration of child sexual abuse in response to the diagnosis. This article further supports the literature reflecting the overall rarity of abnormal anogenital findings in the clinical assessment for sexual abuse.