Retained foreign object - Anogenital in
A vaginal foreign object can lead to secondary infection. Failure to resolve and/or unresponsiveness and recurrence after appropriate treatment, based on a positive culture of vaginal discharge, should raise suspicion for a retained foreign object. Since a vaginal exam is often difficult in a child, a foreign object may not be ruled out until an appropriate exam is completed under anesthesia. Placing the child in a knee-chest position facilitates the examination and visualization of a vaginal foreign object in a prepubescent girl. In addition, a rectal exam may reveal a foreign object via palpation.
Childhood sexual abuse is a problem of epidemic proportions affecting children of all ages and economic and cultural backgrounds. Although awareness is increasing, it is often challenging to differentiate findings attributable to child abuse from those of other benign anogenital skin conditions.
T19.2XXA – Foreign body in vulva and vagina, initial encounter
142661000119102 – Retained foreign body
Differential Diagnosis & Pitfalls
- Sexual abuse
- Chlamydial infection
- Irritant dermatitis
- Lichen sclerosus
- Atopic dermatitis
- Non-sexually transmitted infections: Staphylococcus, Streptococcus, Enterococcus, Shigella, Salmonella, Candida albicans, Enterobius vermicularis, and Escherichia coli.
- Sexually transmitted infections secondary to intimate sexual contact: Neisseria gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, and Gardnerella vaginalis.
- Poor hygiene