Postmortem perianal findings in children

The American Journal of Forensic Medicine and Pathology
John McCannS Wirtz

Abstract

The postmortem finding of anal dilation or an exposed pectinate line in children who have died under suspicious circumstances continues to raise the concern of possible sexual abuse. The following multicenter, collaborative study was designed to help address that question. Sixty-five subjects, ranging in age from birth to 17 years, were autopsied at three different sites. A standard protocol along with 35-mm cameras were used to record the results. Thirty-eight (58%) subjects were boys, and 27 (42%) were girls. Forty-two (65%) were white, 10 (15%) African-American, five (8%) Asian, three (5%) white Hispanic and five (8%) other. Fifty-seven (88%) were in Tanner stage I of secondary sexual development. Thirty-four (52%) died of natural causes, 26 (40%) from accidental injuries, three (5%) from other causes, and four (6%) as a result of a homicide. Forty-eight subjects (74%) had some dilation of the anal sphincters. In 21 children (32%), the entire anal canal, including the rectal ampulla, could be visualized. In another 21 (32%) subjects, the pectinate line was exposed. Only the outer portion of the anal canal opened in six children (10%), whereas 17 (26%) had no dilatation of the anus. Anal laxity led to flattened skin folds in ...Continue Reading

References

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Citations

Aug 2, 2001·Journal of Pediatric and Adolescent Gynecology·D Muram
Sep 1, 2004·Journal of Clinical Forensic Medicine·P Schmidt, B Madea
Jul 9, 2013·International Journal of Legal Medicine·F AmbrosettiC Cattaneo
Jan 1, 2008·Forensic Science, Medicine, and Pathology·Roger W ByardGuy N Rutty
Nov 26, 2011·Forensic Science, Medicine, and Pathology·Michael S Pollanen
Jul 3, 1998·Child Abuse & Neglect·J McCann
Oct 21, 2015·Journal of Pediatric and Adolescent Gynecology·Guido PellettiRossella Snenghi
Mar 24, 2012·The American Journal of Forensic Medicine and Pathology·Vickie WilloughbyLakshmanan Sathyavagiswaran
Mar 30, 2000·The American Journal of Forensic Medicine and Pathology·B G Stephens
Aug 22, 2009·The American Journal of Forensic Medicine and Pathology·Dennis J ChuteRobert J Bready
Jan 14, 1999·The American Journal of Forensic Medicine and Pathology·W Q Sturner

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