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Medical Child Abuse: A Case Presenting as Anogenital Bleeding of Unknown Origin in an Older Child

Lisa M Moon1, Krista J Childress1, Reena Isaac2

  • 1Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.

Journal of Pediatric and Adolescent Gynecology
|July 11, 2018
PubMed

Insights

Medical child abuse can be difficult to diagnose in older children presenting with unusual symptoms. In this case, trial separation from the mother was key to diagnosing medical child abuse.

Area of Science:

  • Pediatrics
  • Forensic Medicine
  • Child Abuse

Background:

  • Medical child abuse (MCA) presents diagnostic challenges, especially in older children with atypical symptoms.
  • Unusual presentations can obscure the diagnosis of MCA.

Observation:

  • A 7-year-old child with a complex history presented with unexplained anogenital bleeding.
  • Extensive diagnostic workup, including laboratory and imaging studies, yielded no identifiable cause.
  • Forensic testing confirmed the blood originated from the patient.

Findings:

  • Trial separation from the mother proved both diagnostic and therapeutic.
  • This case highlights that older children can be victims of MCA and may even participate in symptom falsification.

Implications:

  • Medical child abuse should be considered in the differential diagnosis when clinical presentation and diagnostic findings are incongruent.
  • Healthcare providers must maintain a high index of suspicion for MCA in complex pediatric cases.
  • Early recognition and intervention are crucial for the safety and well-being of child victims.
Abstract

Keywords:
Genital bleedingMedical child abuseMunchausen by proxyPediatricVaginal bleeding

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