Evaluación médico-legal del abuso sexual infantil. revisión y actualización

Abstract

Diagnosing child sexual abuse is usually a hard challenge for Forensic Doctors. In most cases, the sex offender is a relative or somebody who is really close to the victim, and at early ages there is seldom any anal or vaginal intercourse. As a result, findings in these cases are completely different from the once found in adult victims who suffered from sexual attacks. We need to learn about the sensitivity and specificity of findings that may be associated with child se-xual abuse, in order to avoid ignoring real cases or perform mistaken diagnosis, since both situations cause significant harm to the boy, the girl and their families. We specially need to understand the low importance of a negative anal/ge-nital exam and, at the same time, consider we face a case of abuse whenever abnormal anal or genital findings are present. We emphasize on the value of interviewing the alleged victim, and the need for it to be carried out according to minimum standards. The present article comprises the diagnostic value of child sexual abuse signs and symptoms and as a conclusion suggests ten rules to be generally applied in medico-legal work in the field.