Recently, the child growth and development outpatient clinic/endocrine clinic of the pediatric care department of Jin'an District Maternal and Child Health Hospital in Lu'an City received a special 5-year-old girl Xixi (pseudonym), Xixi for more than a year has a small amount of vaginal bleeding for unknown reasons and is accompanied by a fishy smell.
After a detailed examination and physical examination of the girl, Cai Wenjuan, the senior expert of the Child Growth and Development Clinic/Endocrinology Clinic of the Department of Child Care, found that there was no breast development, no pubic hair, axillary hair development, and no sudden increase in height, and then arranged a series of related examinations, such as breast and uterine appendage B ultrasound, bone age assessment and endocrine hormone examination, and the examination results were normal except for the girl's bone age, which was about 3 years older, and basically ruled out precocious puberty. However, after a detailed examination and auxiliary examination, Director Cai Wenjuan highly suspected that the girl had a vaginal foreign body, and referred Xixi to other departments in the hospital.
Gynecologic and surgical hysteroscopic removal of foreign bodies
After being admitted to the hospital, Director Pan Zhubin and gynecologist Chen Wan of the Provincial Children's Hospital were invited to conduct a multidisciplinary consultation and discussion, and excreted precocious puberty and gynecological diseases, and made a preliminary diagnosis: intravaginal foreign body. Hysteroscopic vaginal exploration is recommended for the presence of foreign bodies.
Director Dou Junfeng told Xixi's parents: "Although it is not yet certain what a 'foreign body' is, because children are curious about putting small objects into the vagina, it also happens clinically from time to time, and they can be removed through a hysteroscopy, so there is no need to worry too much." ”
However, it is not easy to perform hysteroscopy and remove foreign bodies for 5-year-old girls, on the one hand, the child is young and does not know how to cooperate, on the other hand, the child's reproductive organs are not yet mature, the vaginal epithelium is thin and has few folds, the vagina is easily damaged during examination, and the vaginal opening is narrow, these factors increase the difficulty of hysteroscopy and foreign body removal. Surgeons and gynecologists, who have extremely rich minimally invasive laparoscopic techniques, decided to use hysteroscopy to remove the foreign body from the vagina.
During the operation, it can be clearly seen on the display screen that there is a gauze-shaped foreign body in the skirt of Xixi's vagina, which has formed chronic inflammatory changes on the vaginal wall due to the long time in the vagina and the pus on the surface. With the full cooperation of the anesthesiology department and the operating room team, the hysteroscopic foreign body removal was successfully performed.
After the surgery, Hee Hee recovered well.
Experts from Jin'an District Maternal and Child Health Hospital said:
There are a variety of things that are usually encountered in clinical practice and stuffed into the vagina, which may be due to the following reasons: 1. Young girls and other items such as buttons, bottle caps, fruit cores, beans and other items are put into the vagina due to curiosity and other reasons; 2. Occasionally, small worms burrow into the vagina; 3. When encountering indecent or sexual assault, the abuser stuffs objects into the vagina; 4. Patients with mental illness put various items into the vagina.
Parents should educate adolescents and children about sexual health so that children can learn to protect themselves. For younger children, try not to leave the sight of their parents and do not wear open crotch pants. Parents should take a proper view of their children's curiosity and carry out the right sex education according to the age of their children. For example, you can't take off your pants in front of strangers, you can't stuff foreign objects into your body casually, and the differences between boys and girls. Cultivate good hygiene habits, ensure that the vulva is washed every day, change underwear frequently, and teach children the correct hygiene knowledge.
In addition, a prolonged presence of a vaginal foreign body may lead to vaginal bleeding, infection, and in severe cases, vaginal adhesions, strictures, and even vaginal bladder fistula, vaginalectal fistula. Parents need to observe their children's vulva, some children have a foreign body in the vagina, if they do not tell their parents, after a long time, there may be vaginal odor or vaginal bleeding, if you find blood or discharge on your child's underwear, you should go to a professional children's medical institution in time. (Manuscript source: Department of Pediatrics: Cai Chuanlan, Department of Surgery: Pei Shijie)