Journal of forensic and legal medicine · 2026
Suspicion of sexual assault in female perineal injuries to formulate guidelines for clinicians - A retrospective study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sahu Sindhu Sudha, Padhi Kimi Soumya, Vasudevan Greeshma, Mohanty Manoj Kumar
Аннотация
BACKGROUND: Perineal injuries (PI) in females and children may result from blunt trauma, impalement, road traffic accidents, or sexual assault, with presentations ranging from superficial abrasions to deep lacerations involving genitourinary, anorectal, or intra-abdominal structures. Differentiating accidental trauma from sexual assault remains a clinical and medicolegal challenge, particularly when history is unclear or inconsistent.
METHODS: A retrospective analysis of challenging perineal injury cases presenting between 2019 and 2025 at a tertiary care centre was conducted. Cases included isolated perineal injuries, perineal injuries with associated bodily trauma, and extensive perineal injuries following reported consensual sexual activity. Clinical presentation, injury mechanisms, medicolegal dilemmas, consent-related issues, and evidence collection challenges were evaluated.
RESULTS AND DISCUSSION: A total of 532 cases of trauma and assault of female patients were forensically assessed during the study period and cases with perineal and/or genital injuries, history of sexual assault and suspicious cases wereevaluated for major challenges faced.These included injury-to-history mismatch, delayed presentation, previously treated referred cases with dressings or clots, absence of witnesses, and differentiation of impalement trauma from sexual assault. Variability in consent scenarios and evidence preservation difficulties were frequently encountered. Ten cases representing the spectrum of diagnostic and forensic dilemmas were choosen for discussion. A structured clinical-forensic evaluation strategy was formulated to guide history assessment, injury correlation, consent procedures, forensic evidence preservation, etc. CONCLUSION: A systematic interdisciplinary approach with increased awareness of medicolegal responsibilities can improve early evidence preservation, support accurate injury interpretation, and reduce the risk of missed forensic evidence in suspected sexual assault-related perineal injuries.
METHODS: A retrospective analysis of challenging perineal injury cases presenting between 2019 and 2025 at a tertiary care centre was conducted. Cases included isolated perineal injuries, perineal injuries with associated bodily trauma, and extensive perineal injuries following reported consensual sexual activity. Clinical presentation, injury mechanisms, medicolegal dilemmas, consent-related issues, and evidence collection challenges were evaluated.
RESULTS AND DISCUSSION: A total of 532 cases of trauma and assault of female patients were forensically assessed during the study period and cases with perineal and/or genital injuries, history of sexual assault and suspicious cases wereevaluated for major challenges faced.These included injury-to-history mismatch, delayed presentation, previously treated referred cases with dressings or clots, absence of witnesses, and differentiation of impalement trauma from sexual assault. Variability in consent scenarios and evidence preservation difficulties were frequently encountered. Ten cases representing the spectrum of diagnostic and forensic dilemmas were choosen for discussion. A structured clinical-forensic evaluation strategy was formulated to guide history assessment, injury correlation, consent procedures, forensic evidence preservation, etc. CONCLUSION: A systematic interdisciplinary approach with increased awareness of medicolegal responsibilities can improve early evidence preservation, support accurate injury interpretation, and reduce the risk of missed forensic evidence in suspected sexual assault-related perineal injuries.