Buggery in childhood--a common syndrome of child abuse

18 girls and 17 boys, aged 14 months to 8 years, with a history and physical signs of buggery were selected from a large series of sexually abused children seen by two paediatricians in Leeds, child population 146 000, over 8 months. In 27 children disclosure of abuse by the child or perpetrator (most commonly the father) was recorded. Anal findings on inspection included fissures, dilatation and reflex dilatation, loss of sphincter, shortening and eversion of the anal canal, external venous congestion, and generalised reddening and thickening of perianal tissues. Vaginal signs of dilatation or marked redness were found in 14 girls but penile penetration of the vagina was uncommon. Associated findings included non-accidental injury, emotional deprivation and failure to thrive, developmental delay, and behavioural disturbance. Buggery in young children, including infants and toddlers, is a serious, common, and under-reported type of child abuse.