Özet:

Introduction and Purpose: in the assessment of the incidents of sexual abuse against the child; the multi-faceted assessment of the family and the child without being traumatized, the reporting of the case, protection, health, education, etc. Measures should be taken to intervene. The distinctive diagnosis is part of this process. The study aims to emphasize the importance of judicial medical assessment in the process of placing a distinctive diagnosis in such cases.   He is an eight-year-old boy. Seven-year-old self-clean claims that his son has been sexually abused several times in the last month and about 10 days after the date of the last incident, the little girl has difficulty sitting on the pop, frequently going to the toilet, excrete change complaints, the self-clean has been brought to the emergency unit of a university hospital in the Child Health and Diseases Department at night. The small application was taken to three private hospitals before, but it was recommended to be taken to the university hospital due to the characteristic of the judicial fact. The clinical doctor who first examined the case called the teacher of the Department of Judicial Medicine and got an idea of how to act. The instructions were made to inform the hospital police about the incident and not to be detained under surveillance. On the next day, doctors from the fields of medicine, such as Women’s Diseases and Birth, Child Surgery, Child Mental Health Diseases and Judicial Medicine, gathered together to assess the fact. In the anal examination of the child, four deep laserations have been identified in the inner part of the anal mucous, which cannot be observed with the naked eye from the outside, and with the findings of mental trauma that arise after the incident in the child, it has been found to be a precise medical evidence that he has been exposed to sexual abuse from the anal path. Discussions and Results: In such cases, the risk of the injuries being displaced in a deep area due to the detection of traumatic injury in the genital area and the risk of the injuries not being properly identified and not evaluated by an experienced team. Also, the group of doctors who first saw these phenomena, who often worked in emergency units and focused on therapeutic medicine, have gained experience in this field and therefore have not received a special training to assess the legal medical scale of the incident, will inevitably experience difficulties in placing a distinctive diagnosis. The important factor in obtaining the correct diagnosis is that a experienced clinical physician in the phase of judicial incident assessment in emergency units receives judicial medical support with a multidisciplinary approach. Therefore, in the units that offer complex structures such as the university; childhood sexual abuse facts should be assessed as comprehensive and multidisciplinary and should be included in educational programs for the assessment of judicial facts in service education.

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