Abnormal anus and hymen in a toddler: A case report.

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.