Sir.—The article by Bays and Jenny1 in the December 1990 issue of AJDC is a valuable review of the many physical findings that can be confused with sexual abuse. The authors stated that forceful abduction of the legs may cause splitting injuries of midline structures. I would like to report a case in which forceful abduction of the buttocks coupled with misrecognition of a normal structure led to a false assumption of sexual abuse.
Report of a Case.—A 12-month-old white girl was brought to the office by her mother. The mother gave a specific history that the father, who had only weekend custody, had had rectal intercourse with her daughter. The mother stated that the child had difficulty with bowel movements after a weekend visitation. The child had already been examined by an emergency department physician and another local pediatrician. Without prompting, the mother then suddenly demonstrated
BAKER RB. Anal Fissure Produced by Examination for Sexual Abuse. Am J Dis Child. 1991;145(8):848-849. doi:10.1001/archpedi.1991.02160080022010