Peds

Vaginal Injury in Girls

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Vaginal Injury in Girls, Vulvar Trauma in Children, Pediatric Vaginal Injury

  • See Also
  1. Abnormal Uterine Bleeding Causes
  • Precautions
  1. Observe for signs of pediatric sexual abuse and Nonaccidental Trauma
    1. However, Most cases will be accidental
  2. Accidental straddle injury causes
    1. Bike accidents or straddle injuries
    2. Bed frames
    3. Playground equipment
    4. Bathtub fixtures
  • Management
  • Blunt injury (most cases)
  1. Superficial Skin Tearing or Contusion (e.g. vulvar Hematoma)
    1. Most common site occurs at the fossa between labial majora and labia minora
    2. Local bleeding may occur from site
    3. Perform gentle hygiene with clear water sitz baths multiple times daily for several days
    4. Ice or cool pack to the area up to 20 min/hour
    5. Analgesics as needed
    6. Frequently empty Bladder
    7. If Dysuria, child may urinate in the sitz bath
  2. Small vulvar Lacerations (<3 cm) without bleeding
    1. Suturing is NOT required
    2. Apply topical Emollient (e.g. aquaphor or Bacitracin) to the area several times daily until healed
  3. Deep Lacerations (esp. involving clitoris, Urethra, labia minora, vaginal introitus, posterior fourchette)
    1. Consider pediatric gynecology or pediatric surgery for better functional and cosmetic closure
  • Management
  • Sharp injury (uncommon)
  1. Higher risk for deeper penetrating injury
  2. Consult pediatric gynecology or surgery if signs penetrating injury (esp. blood from introitus)
    1. Urgent vaginal endoscopy may be indicated
  • References
  1. Claudius and Willner in Herbert (2019) EM:Rap 19(1): 2-4
  2. Rucker (2025) Crit Dec Emerg Med 39(9): 4-12