Local examination revealed a thick, foul smelling, and mucopurulent discharge at vulvar introitus. As there were many relatives at home on account of the recent bereavement, the grandmother was not sure of any sexual abuse. The child had lost her father 10 days ago. reported a three-and-half-year-old girl with a complaint of dysuria and foul smelling mucopurulent discharge from the vagina for three days. Although this is not always the case, the possibility should be kept in mind while examining any child with vulvovaginal symptoms ( 4, 5). The presence of vaginal foreign body may be an indication of sexual abuse. It is appropriate for the health care providers to ask questions related to sexual activity and sexual or physical abuse. In addition to obtaining specific information about a possible vaginal foreign body, a health care provider will perform a general history and physical examination as well. Children may not be able to supply the history of an object placed in the vagina, however, some children will say that they have lost an object in their vagina. Vaginal foreign bodies are more commonly observed in children than in adolescent or adult women. In this case, it could not be established whether the nail had been inserted by the child herself or by another child or an adult. Fortunately the cooperation of child was very good and we could discharge the nail by doing the TR (rectal exam with finger) and pushing the nail to midline of vaginal canal and extraction of nail out of vagina by use of a magnetic mag ( Figure 2). In physical examination of the girl in frog-leg position and by tension of her vulvae labials major, a black point in depth of her vagina through the orifice of hymen was observed, it was the tail of a nail, the hymen was intact and her mother entreated that we discharge the nail without trauma to child hymen. The clinicians did a pelvic X-Ray in Saravan city hospital that showed a big metal nail in the child`s vagina ( Figure 1). Occasionally a tampon or pessary is forgotten or lost and causes discomfort and vaginal discharge ( 4).Ī 4-year-old girl was brought by her mother from Saravan city to the emergency department of gynecology in Ali-Ibn-Abitaleb Hospital of Zahedan University of Medical Sciences in May 2012, with the complaints of a foreign body in her vagina and lower abdominal pain for eight hours. Vaginal foreign bodies in the adults may be a result of a psychiatric disorders or unusual sexual practices. The child is finally often brought to the emergency department with a foul-smelling purulent discharge with or without vaginal bleeding. So this is commonly a problem of children, who may insert a foreign body and not tell their parents. Young children tend to explore all orifices and may place a variety of small objects in the vagina. Foreign bodies may be also inserted for various reasons, as articles of toilet and hygiene, by accident, as therapeutic agents to induce abortion or as contraceptive devices. Small pieces of toilet paper that find their way into the vagina are the most common cases ( 2, 3). Children insert toys, sweets, hairpins, etc. The patient is often mentally retarded or a young child ( 1). Map: A topographic map should accompany you on any trip that involves anything more than a short, impossible-to-miss footpath or frequently visited nature trail.An extraordinary variety of foreign bodies may be found in the vagina, including safety pins, hair grips, pencils and small jam jars.And for help figuring out what else to bring with you, check out our hiking checklists.Ĭontemporary navigation tools include five essentials for traveling in the backcountry: a map, compass, altimeter watch, GPS device and personal locator beacon (PLB). When deciding what to bring, consider factors like weather, difficulty, duration, and distance from help.Ĭontinue reading below for more information about each of the Ten Essential systems. On a longer, more complex outing, you might decide you want all those tools to help you find your way. For example, on a short day hike that’s easy to navigate you might choose to take a map, compass and PLB, but leave your GPS and altimeter behind. The exact items from each system that you take can be tailored to the trip you’re taking.
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