Table of Contents

ABSTRACT

Most of the care provided by pediatric and other physicians in hospital settings is related to the injuries associated with physical abuse. Less common in the medical system is child sexual abuse. In addition to the general approaches previously discussed, we review the special considerations for obtaining medical history, providing trauma informed care, and preparing the child for the anogenital exam. Pediatric trainees receive limited training in this area, and we focus on normal anogenital examination findings and their variations and then discuss genital as well as anal injuries. Pediatric trainees learn about sexually transmitted infections (STIs) in their adolescent medicine rotations, but we enhance this by reviewing their presentation and significance in the prepubertal child. There are special procedures required after acute sexual assault and we conclude this chapter by reviewing the growing problems of sex trafficking and internet exploitation.