Objective: We have analyzed our population in regards to child sexual abuse during 1994 and propose a diagnostic classification of our findings.
Patients and methods: We reviewed retrospectively 18 cases of abuse, collection in each case the following data: age, sex, reason for the consultation, family situation, perpetrator, positive clinical history or not, physical findings, psychological disorders and complementary examinations. We established 4 classification levels: normal, compatible with abuse, suspicious and sexual contact or certain penetration.
Results: The number of children attended was 18. Thirteen (72%) were female. The youngest was 1 month old and the oldest 14.5 years. The clinical history was positive in 6 cases. The physical findings allowed a certain diagnostic in 3 cases. Presence of semen was demonstrated in 1 case and 1 positive culture for gonococci was obtained. The final diagnosis was normal in 6 cases, compatible with abuse in 4, suspicious in 3 and certain sexual contact or penetration in 5.
Conclusions: The diagnosis of sexual abuse is very difficult. The clinical history is still necessary due to the fact that physical findings and complementary tests tend to not be conclusive. We propose that once the information has been evaluated the conclusion be classified into 4 groups: normal, compatible with abuse, suspicious and certain sexual contact or penetration.