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August 1991

Anal Fissure Produced by Examination for Sexual Abuse

Author Affiliations

Kaiser Permanente Medical Group 3955 Bonita Rd Bonita, CA 92002

Am J Dis Child. 1991;145(8):848-849. doi:10.1001/archpedi.1991.02160080022010

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

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