Trauma to the External Genitals 2 (Genital Bleeding)

10.10-year-old girl with impalement lesion of the vulva. Minimal, externally visible genital bleeding; notice the spot of blood at the inner side of the left buttock. Enormous swelling of the left labium minus with a dark-blue skin on the lower end and evacuation of some blood. In impalement lesions and of the combined contusions, the vulva may exhibit only abrasions and contusions instead of lacerations in the individual case, but still develop grotesque hematomas of the soft tissue; these hematomas may void secondarily. In this case, the micturition should be maintained by a catheter; the proceeding is the same as in gebl_9_n.jpg, and infection must be avoided by prophylactic antibiotics. In case of uncertain attendant phenomena, sexual abuse must be considered in children with genital bleeding with or without externally visible lesions, and must be reported to the institute of forensic medicine.