[Sexual abuse in adolescence: patient assessment, necessity and meaning of the physical examination]

The objective of this paper is to report on the characteristics of sexual abuse in adolescence, on the medical evaluation and interpretation of findings and on the necessity of a multidisciplinary intervention. Sexual abuse is a common problem affecting children and adolescents, males and females of any age or socio-economic class. 10-22% of adolescents are victims of sexual abuse. They engage more frequently in risk-taking behaviours, such as early sexual activity, unprotected sexual contact with multiple partners (risk of sexually transmitted diseases, of an unwanted pregnancy), substance abuse, delinquency, school failure or suicide. Professionals who deal with adolescents should be aware of the devastating medical and psychosocial sequelae of sexual abuse and should be able to recognize it, incorporating questions regarding victimization into the psycho-social or sexual history. A medical examination, including an external anogenital inspection and in selected cases a pelvic examination, should always be performed. It is important to acknowledge that normal anogenital findings do not exclude sexual abuse and that a multidisciplinary medical-psychosocial evaluation is mandatory.