Isolated upper vaginal wall laceration in an underage: a need to re-examine child sexual abuse in South-South Nigeria.

Abstract

Child sexual abuse includes any sexual act between a minor and an adult, or between two minors, when one exerts power over the other. It involves forcing, coercing or persuading a child to engage in any type of sexual act. It also involves non-contact acts such as exhibitionism, exposure to pornography, voyeurism, and communicating in a sexual manner by phone or internet. An eight-year-old girl was rushed to the gynaecological emergency unit of the Federal medical centre, Yenagoa with complaints of a three-hour history of sudden onset vaginal bleeding following a fall astride in their house. There was no injury to the vulva and the child and her relatives denied any form of sexual abuse by anyone within or outside their home. She had examination under anaesthesia in theatre and a 3 cm laceration was identified at the proximal one-third of the left lateral wall of the vagina, covered with a blood clot; not bleeding actively. Repair was done and she was subsequently discharged home on the fourth post-operative day after counselling of mother and child. Child sexual abuse is common in our environment. Education and bonding with children, education of the public via outreaches, social media campaigns and other means possible, and improvement in the socio-economic situation of people will help reduce the incidence of child sexual abuse and encourage reporting and early disclosure where they occur.