Attached
Introduction
Vaginal bleeding after first week o f life, but before menarche, is always abnormal and needs diagnostic evaluation.
This may be the first evidence o f sexual abuse. False allegations and suspicion among guardians may lead to
serious consequences on the child as well as the suspects.
Case history
An eight month old baby living in a rubber estate was presented with sudden onset vaginal bleeding for two days.
Bleeding disorders were excluded and the child was referred to a Judicial Medical Officer (JM O) to exclude sexual
abuse. Medico-legal examination done on the third day after the incident revealed 1.2cm x 1cm bleb o f hemorrhage
on labia minora. An isolated underlying 0.5cm abrasion appeared to cause active bleeding. There was no past
history o f similar episodes. Grandmother named a few suspects and alleged sexual abuse. Later, mother mentioned
that a leech was found in the room a few hours after the incident.
Conclusions
Unusual vaginal bleeding in children should be investigated thoroughly to achieve justice, exclude false allegations
and protect children and guardians from stigma. Forensic pathologists must be aware o f fauna o f thier working area
because they could cause medico-legally significant injuries.
