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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir los hallazgos cl&#237;nicos en los ni&#241;os atendidosen una unidad de abusos sexuales infantiles&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Revisi&#243;n retrospectiva de las historias de los pacientes con sospecha de abuso sexual atendidos en el hospital desde enero de 1992 hasta abril de 2000&#46; Se recogieron las variables edad&#44; sexo&#44; necesidad de atenci&#243;n urgente&#44; v&#237;a de llegada&#44; mecanismo de descubrimiento&#44; separaci&#243;n conyugal en los padres&#44; anamnesis&#44; hallazgos f&#237;sicos y exploraciones complementarias&#46; Despu&#233;s del estudio se clasificaron en 4 grupos&#58; normal&#44; compatible&#44; muy probable o seguro de contacto sexual&#46; En los casos con alta probabilidad de abuso se recogieron los datos de la identidad del agresor&#44; lugar del abuso&#44; duraci&#243;n y tipo de abuso cometido&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 704 casos&#46; El 75 &#37; eran ni&#241;as&#46; El relato del ni&#241;o fue la forma m&#225;s frecuente de descubrimiento del abuso &#40;51&#37;&#41;&#44; la anamnesis fue positiva en el 45 &#37; de ocasiones&#46; La exploraci&#243;n genital fue normal en el 74 &#37; de casos y la anal en el 79 &#37;&#46; En la conclusi&#243;n final&#44; el 40 &#37; fue normal&#44; el 11 &#37;&#44; compatible&#44; el 41 &#37;&#44; alta probabilidad y el 4&#37;&#44; seguro abuso sexual&#46; El abusador fue en el 92&#37; de casos un var&#243;n&#46; Los tocamientos fueron la forma m&#225;s frecuente de agresi&#243;n y en el 25&#37; el abuso dur&#243; m&#225;s de un a&#241;o&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El diagn&#243;stico de abuso sexual es dif&#237;cil y se basa casi siempre en el relato del ni&#241;o&#46; El rendimiento de la exploraci&#243;n y de las exploraciones complementarias es muy bajo&#46; Se propone una clasificaci&#243;n diagn&#243;stica en cuatro niveles&#58; normal&#44; compatible&#44; abuso muy probable y contacto sexual seguro&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe the clinical findings in children treated in a child sexual abuse unit&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We carried out a retrospective study of the clinical histories of children under suspicion of sexual abuse who visited the hospital from January 1992 to April 2000&#46; Data on age&#44; sex&#44; need of urgent medical care&#44; means of arrival&#44;mechanism of discovery of abuse&#44; parental separation&#44; anamnesis&#44; physical findings and complementary investigations were collected&#46; The patients were then classified in four groups&#58; normal&#44; compatible&#44; highly probable or certain sexual contact&#46; In cases with a high probability of abuse&#44; data of the aggressor&#39;s identity&#44; place&#44; duration and type of abuse were also collected&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We studied 704 patients&#46; Seventy-five percent were girls&#46; The child&#39;s account of events was the most frequent means of discovering abuse &#40;51&#37;&#41;&#46; Anamnesis was positive in 45 &#37; of the patients&#44; genital examination was normal in 74&#37; and anal examination was normal in 79 &#37;&#46; According to our classification&#44; 40 &#37; of the patients were normal&#44;11&#37; were compatible&#44; 41&#37; were highly probable and 4&#37; were of certain sexual contact&#46; Ninety-two percent of aggressors were male&#46; Molestation was the most frequent form of abuse and in 25 &#37; of cases abuse took place for more than 1 year&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Diagnosis of sexual abuse is difficult and is almost always based on the child&#39;s account of events&#46; The diagnostic yield of physical examination and complementary investigations is very low&#46; We propose a diagnostic classification of four levels&#58; normal&#44; compatible&#44; highly probable abuse and certain sexual contact&#46;</p>"
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Vol. 54. Núm. 3.
Páginas 243-250 (marzo 2001)
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Vol. 54. Núm. 3.
Páginas 243-250 (marzo 2001)
Acceso a texto completo
Abuso sexual. Experiencia en una unidad funcional de abusos a menores
Sexual abuse. Experience in a child sexual abuse unit
Visitas
53125
J. Pou Fernándeza,
Autor para correspondencia
jpou@hsjdbcn.org

Correspondencia: Servicio de Pediatría. Hospital Sant Joan de Déu. P.° Sant Joan de Déu, 2. Esplugues de Llobregat. 08950 Barcelona
, A. Ruiz Españaa, L.I. Comas Masmitjáa, M.aD. Petitbó Rafatb, M. Ibáñez Fanesb, J. Bassets Marillc
a Servicio de Pediatría. Universidad de Barcelona
b Sección de Psicología. Universidad de Barcelona
c Treball Social. Unidad Integrada Sant Joan de Déu-Hospital Clínic. Universidad de Barcelona
Este artículo ha recibido
Información del artículo
Objetivo

Describir los hallazgos clínicos en los niños atendidosen una unidad de abusos sexuales infantiles.

Pacientes y métodos

Revisión retrospectiva de las historias de los pacientes con sospecha de abuso sexual atendidos en el hospital desde enero de 1992 hasta abril de 2000. Se recogieron las variables edad, sexo, necesidad de atención urgente, vía de llegada, mecanismo de descubrimiento, separación conyugal en los padres, anamnesis, hallazgos físicos y exploraciones complementarias. Después del estudio se clasificaron en 4 grupos: normal, compatible, muy probable o seguro de contacto sexual. En los casos con alta probabilidad de abuso se recogieron los datos de la identidad del agresor, lugar del abuso, duración y tipo de abuso cometido.

Resultados

Se estudiaron 704 casos. El 75 % eran niñas. El relato del niño fue la forma más frecuente de descubrimiento del abuso (51%), la anamnesis fue positiva en el 45 % de ocasiones. La exploración genital fue normal en el 74 % de casos y la anal en el 79 %. En la conclusión final, el 40 % fue normal, el 11 %, compatible, el 41 %, alta probabilidad y el 4%, seguro abuso sexual. El abusador fue en el 92% de casos un varón. Los tocamientos fueron la forma más frecuente de agresión y en el 25% el abuso duró más de un año.

Conclusión

El diagnóstico de abuso sexual es difícil y se basa casi siempre en el relato del niño. El rendimiento de la exploración y de las exploraciones complementarias es muy bajo. Se propone una clasificación diagnóstica en cuatro niveles: normal, compatible, abuso muy probable y contacto sexual seguro.

Palabras clave:
Abuso sexual
Niño
Maltrato infantil
Objective

To describe the clinical findings in children treated in a child sexual abuse unit.

Patients and methods

We carried out a retrospective study of the clinical histories of children under suspicion of sexual abuse who visited the hospital from January 1992 to April 2000. Data on age, sex, need of urgent medical care, means of arrival,mechanism of discovery of abuse, parental separation, anamnesis, physical findings and complementary investigations were collected. The patients were then classified in four groups: normal, compatible, highly probable or certain sexual contact. In cases with a high probability of abuse, data of the aggressor's identity, place, duration and type of abuse were also collected.

Results

We studied 704 patients. Seventy-five percent were girls. The child's account of events was the most frequent means of discovering abuse (51%). Anamnesis was positive in 45 % of the patients, genital examination was normal in 74% and anal examination was normal in 79 %. According to our classification, 40 % of the patients were normal,11% were compatible, 41% were highly probable and 4% were of certain sexual contact. Ninety-two percent of aggressors were male. Molestation was the most frequent form of abuse and in 25 % of cases abuse took place for more than 1 year.

Conclusion

Diagnosis of sexual abuse is difficult and is almost always based on the child's account of events. The diagnostic yield of physical examination and complementary investigations is very low. We propose a diagnostic classification of four levels: normal, compatible, highly probable abuse and certain sexual contact.

Key words:
Sexual abuse
Children
Child abuse
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Copyright © 2001. Asociación Española de Pediatría
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