Genitoanal findings in Puerto Rican children with suspected sexual abuse.

Background: Even though the child sexual abuse literature has described and classified the most common genitoanal findings in children evaluated for suspected sexual abuse, there is scarce information about abused Puerto Rican children. The purpose of this study was to describe the most common genitoanal findings in children referred to the Bio-psychosocial Program for evaluation of suspected sexual abuse between 2003 and 2007.

Methods: A record review of 55 patients was conducted to collect data on genitoanal findings, socio-demographic characteristics and other variables related to the abuse.

Results: Most patients (56.4 %) were between 3-8 years of age. The father was the most common alleged aggressor (25.5%). One third reported anal penetration (34.5%). Most patients (65.5%) had a normal genitoanal exam. A total of 27.3% had genitoanal findings diagnostic of abuse. The most prevalent risk factors were domestic violence (36.4%) and illicit drug abuse (30.9%).

Conclusion: There was a higher prevalence of diagnostic findings (27.3%), including anal injuries (14.5%) compared to other studies. Since most children had a normal genitoanal exam, the child's disclosure is the most important evidence of sexual abuse.