Presence of intravaginal foreign bodies in children evaluated for forensic medicine examination: Two case reports

Abstract

Background: Child sexual abuse can present with a wide range of clinical findings, from severe anogenital injuries to the complete absence of symptoms. Intravaginal foreign bodies may also be observed as potential indicators of abuse. However, they often lead to delayed diagnosis due to their nonspecific clinical presentation. These cases should be thoroughly evaluated from both forensic and medicolegal perspectives, particularly in relation to possible sexual abuse and potential malpractice implications. Case Presentation: We report two cases of girls aged 4 and 11 years who presented with intravaginal foreign bodies. A cylindrical battery was removed from the 4-year-old child. The use of X-ray for diagnosis led to delays in establishing the correct diagnosis. The 11-year-old girl had been receiving antibiotics for three months due to persistent vaginal discharge. At the end of this period, a hair clip was removed from the vagina. In both cases, forensic medical and psychiatric evaluations revealed no evidence of sexual abuse. However, the diagnostic delays in both cases also gave rise to allegations of medical malpractice. Conclusion: Intravaginal foreign bodies should be considered in children with persistent vaginal discharge or bleeding. While ultrasonography is useful for initial evaluation, vaginoscopy is the gold standard for diagnosis. Possible sexual abuse must be assessed, and forensic examination should follow legal reporting. Diagnostic delays may result in malpractice claims.