Vaginal foreign bodies are a complaint occasionally encountered in pediatric clinics and emergency departments, and when pediatric patients present with a vaginal foreign body sexual abuse may not be considered. We describe two children with vaginal foreign bodies who were found to have been sexually abused. Each child had a discharge positive for a sexually transmitted infection despite no disclosure or allegation of abuse. We recommend that all pre-pubertal girls who present with a vaginal foreign body should be considered as possible victims of sexual abuse and should receive a sexual abuse history and testing for sexually transmitted infections.

INTRODUCTION
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Vaginal trauma is injury to the vagina. It can happen during childbirth , sexual assault, and accidental occurrences. This injury often consists of bruising. But in some cases, severe hemorrhage can be a concern that requires immediate medical attention. In adults, the vagina is largely protected from trauma due to the protective function of the mons pubis and labia majora.
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Signs of sexual abuse may not be apparent without an examination of the genital area. These signs include:. Vaginal bleeding in a child before the beginning of menstruation is abnormal, as are other vaginal or genital symptoms such as sores, warts, pain, or unusual discharge. Abnormal vaginal bleeding may be caused by physical or sexual abuse that injures the abdominal or vaginal area. Vaginal bleeding that is caused by abuse often is the result of minor physical injuries that will get better on their own or with home treatment. You may feel uneasy if your child's doctor brings up the issue of abuse. But doctors have a professional duty and legal obligation to evaluate the possibility of abuse.
Signs of sexual abuse may not be apparent without an examination of the genital area. These signs include:. Vaginal bleeding in a child before the beginning of menstruation is abnormal, as are other vaginal or genital symptoms such as sores, warts, pain, or unusual discharge.