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The examination of a non-cooperative, resistant child should be postponed, the repetition of the physical examination should be avoided, if there is any suspicion about the presence of physical symptoms in the story or if the incident occurred within the last 72 hours, the Forensic Medicine Specialist should be informed. In the first consultation, the physician should prepare the child for a genital examination, but privacy should be preserved. There should be as few people as possible in the examination. Most victims find physical examination traumatic. Therefore, the approach of the medical staff to the event should be gentle and reassuring. If the child is very young, the examination should be done under general anesthesia.

During the examinations of abused girls, it is necessary to determine the stage of sexual development, the size of the breasts, and the hair growth in the pubic region. It is important to identify and record this information because there may be changes in the sexual development stage of the child between the time the incident takes place and the date the court is due. In the gynecological examination, the general physical condition of the child should be recorded first. The condition of the patient’s clothing (blood stains, general condition, emotional state and hygienic condition) should be carefully recorded.

Areas of traumatic lesions and their colors should be specified in the general physical examination. Among these findings, especially those seen in the arms, neck and legs are significant in terms of abuse. After the general physical examination, the genital area is examined.

It is possible to examine most children in a room equipped to examine young children. Most children do not find any difficulties in this examination. During the external genital examination, it is important to tell the child what to do and to ask him / her to help. In children under seven years of age, genital examination while on the mother’s lap can make things easier. There is a great trauma in cases with vaginal penetration, surgery room and general anesthesia are required for examination and treatment. However, in many children, physical findings are less dramatic or absent. Some types of abuse are not physically evident. In some cases, even if there are physical injuries, this happens to the physician weeks, months or even years after the event. Over time, semen and other material wash away and most wounds heal. If this is the case, physical findings depend on the trauma the victim suffered.

Minimal trauma causes small wounds that heal in a short time and do not leave permanent scars. Deep lacerations heal in a longer time and leave permanent scars. Vulval irritations are a common finding in young children. These may be due to inadequate local hygiene, itching due to local infection, and wetness from the diaper. There are no well-defined criteria or accepted terminology for classifying the physical manifestations of sexual abuse. Different words are used to describe the same findings. Physical findings are classified for prepubertal girls.

2.Nonspecific findings: Genital anomalies that may result from sexual abuse, but can also be seen without it, such as inflammation and itching. These findings may be due to poor hygiene of the area or a nonspecific infection.

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