Fast Five Quiz: Addressing Sexual Assault

Richard H. Sinert, DO

Disclosures

May 08, 2019

Colposcopy, where available, may have considerable value in documentation because it allows photographic recording of injuries. Anoscopy may be performed in male victims, and it may be combined with colposcopy in female victims. Evidence suggests that if speculum examination is performed before toluidine blue application to the posterior fourchette (to enhance small lesions that may occur during forceful genital penetration), the speculum itself may cause small lesions that will take up the dye. These iatrogenic lesions will be seen on colposcopy. Clinicians should consider deferring speculum examination until after external colposcopy if toluidine blue is to be used.

Imaging studies are only indicated for evaluation of comorbid trauma. To collect evidence, most hospitals have a prepackaged rape kit with the necessary equipment and detailed instructions. However, if the sexual assault victim presents 72 hours after the event (96 hours if the victim is a child), the evidence collection kit is no longer needed for legal documentation of the case, although some authors have reported finding evidence in children beyond this time frame.

Read more on the workup of patients who have experienced sexual assault.

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