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Abnormal anus and hymen in a toddler: A case report
Nancy D Kellogg1,2, Lora R Spiller1,2
1Division of Child Abuse, Department of Pediatrics, University of Texas Health Science Center at San Antonio, TX, USA.
SAGE Open Medical Case Reports
|April 29, 2025
Summary
A young child presented with genital concerns, revealing a perineal defect and posterior hymen absence. Further examination confirmed a perineal fistula, highlighting the need for thorough newborn anogenital assessments.
Area of Science:
- Pediatric Surgery
- Forensic Medicine
- Anatomy
Background:
- A 2-year-old girl presented with genital complaints, raising concerns for sexual abuse.
- Physical examination revealed a perineal defect and absence of a posterior hymen segment, with no history of trauma.
- No other signs of abuse or neglect were observed.
Observation:
- A 2-year-old female presented with genital complaints, exhibiting a perineal defect and absent posterior hymen segment.
- Physical examination revealed no other signs of abuse or neglect.
- A perineal fistula was confirmed during an exam under anesthesia.
Findings:
- The presence of a large posterior hymenal defect, typically associated with trauma, co-occurred with an anatomical variant of the anus and perineum.
- The etiology of both the hymenal defect and the anatomical variant remains unclear, questioning a purely traumatic cause.
Implications:
- This case emphasizes the critical need for meticulous anogenital examinations in newborns to document anatomical variants.
- Early identification of congenital anomalies can prevent misdiagnosis and inappropriate interventions, particularly in cases with potential abuse concerns.
- Comprehensive documentation of newborn anogenital structures is crucial for future medical evaluations and forensic assessments.
