Ergenlik öncesi bir kızda vajinada yabancı cisim
Yükleniyor...
Tarih
2025
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Türkiye Klinikleri Yayınevi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kız çocuklarında tekrarlayan vajinal akıntı ya da kanama yakınması, özellikle standart tedaviye dirençli ise vajinada yabancı cisim varlığını düşündürmelidir. En sık tuvalet kâğıdı saptanırken, madeni para, boncuk, küçük oyuncaklar ve çengelli iğne gibi farklı objeler de bildirilmiştir. Bu nedenle, benzer semptomlarla başvuran hastalarda ayrıntılı değerlendirme kritik öneme sahiptir. Sekiz yaşında bir kız çocuğu, 4 aydır aralıklı âdet kanaması olduğu ileri sürülerek polikliniğe getirildi. Ağrı, ateş ve travma öyküsü yoktu. Dış merkezde yapılan tetkiklerde erken puberte ve koagülasyon bozukluğu dışlanmış, pelvik görüntüleme normal bulunmuştu. Cinsel istismar açısından çocuk ve aile ile ayrı ayrı görüşüldü, cinsel istismar dışlandı. Fizik muayenede vulvada ciltte hiperemi dışında patoloji saptanmadı. Külotunda kahverengi akıntı görüldü. Laboratuvar incelemelerinde anormallik yoktu. Kadın hastalıkları ve doğum ana bilim dalından konsültasyon istendi, vajinada yabancı cisim görülerek çok küçük bir parça tuvalet kâğıdı çıkarıldı. Vajinadan kanama olgularında ayırıcı tanıda vulvovajinit, yabancı cisim, cinsel istismar, travma, puberte prekoks ve tümörler yer almalıdır. Puberte öncesi ortaya çıkan vajinal kanamalarda öncelikle yabancı cisim düşünülmelidir.
A presence of a foreign body in the vagina should be considered in prepubertal girls presenting with recurrent or persistent vaginal discharge or bleeding complaints, especially if they are resistant to standard treatment. While toilet paper was most frequently detected, different objects such as coins, beads, small toys and safety pins were also reported. Therefore, detailed evaluation is critical in patients presenting with similar symptoms. An eight-year-old girl was brought to the outpatient clinic because it was claimed that she had been having intermittent menstrual bleeding for four months. There was no history of pain, fever or trauma. In the examinations performed at an external center, early puberty and coagulation disorder were excluded, and pelvic imaging was found to be normal. In terms of sexual abuse, the child and the family were interviewed separately, and sexual abuse was excluded. On physical examination, no pathology was detected other than hyperemia on the skin of the vulva. Brown discharge was seen in her panties. There was no abnormality in laboratory examinations. In the case that was consulted to the department of gynecology and obstetrics for differential diagnosis, a foreign body was seen in the vagina and a very small piece of toilet paper was removed. In cases of vaginal bleeding, the differential diagnosis should include vulvovaginitis, foreign body, sexual abuse, trauma, precocious puberty and tumors. In vaginal bleeding that occurs before puberty, a foreign body should be considered first.
A presence of a foreign body in the vagina should be considered in prepubertal girls presenting with recurrent or persistent vaginal discharge or bleeding complaints, especially if they are resistant to standard treatment. While toilet paper was most frequently detected, different objects such as coins, beads, small toys and safety pins were also reported. Therefore, detailed evaluation is critical in patients presenting with similar symptoms. An eight-year-old girl was brought to the outpatient clinic because it was claimed that she had been having intermittent menstrual bleeding for four months. There was no history of pain, fever or trauma. In the examinations performed at an external center, early puberty and coagulation disorder were excluded, and pelvic imaging was found to be normal. In terms of sexual abuse, the child and the family were interviewed separately, and sexual abuse was excluded. On physical examination, no pathology was detected other than hyperemia on the skin of the vulva. Brown discharge was seen in her panties. There was no abnormality in laboratory examinations. In the case that was consulted to the department of gynecology and obstetrics for differential diagnosis, a foreign body was seen in the vagina and a very small piece of toilet paper was removed. In cases of vaginal bleeding, the differential diagnosis should include vulvovaginitis, foreign body, sexual abuse, trauma, precocious puberty and tumors. In vaginal bleeding that occurs before puberty, a foreign body should be considered first.
Açıklama
Anahtar Kelimeler
Puberte Öncesi, Vajinal Kanama, Vajinal Akıntı, Yabancı Cisim, Prepuberty, Vaginal Bleeding, Vaginal Discharge, Foreign Body
Kaynak
Türkiye Klinikleri Pediatri Dergisi
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
Sayı
Künye
Uğur Baysal, S., Totur, G., & Yavuz, O. (2025). Ergenlik öncesi bir kızda vajinada yabancı cisim. Türkiye Klinikleri Pediatri Dergisi. https://doi.org/10.5336/pediatr.2024-105114
