Pediatric Vaginal Trauma

  • Etiology: Blunt force trauma
  • Imaging:
    — Vagina may be filled with fluid
    — Vaginal wall tears may be seen
  • DDX:
  • Complications: Urethral injury may also be present
  • Treatment: Surgical
  • Clinical: May present with vaginal bleeding

Radiology Cases of Vaginal Trauma

Radiology Cases of Vaginal Trauma and Urethral Laceration

CT of vaginal laceration and VCUG of urethral laceration
Axial CT with contrast of the lower pelvis (above left) shows a contrast-fluid level in the bladder in the anterior part of the pelvis along with a fluid-filled vagina in the middle of the pelvis that lies anterior to the rectum. There is also free fluid noted around the bladder. At a lower level in the CT (below left) the left wall of the vagina is seen to be completely disrupted and discontinuous. AP image from the voiding phase of a voiding cystourethrogram exam obtained a month later (right) shows contrast leaking out of the left side of the urethra.

Radiology Cases of Vaginal Trauma and Rectal Trauma and Extraperitoneal Bladder Trauma

CT of pediatric vaginal trauma and extraperitoneal bladder rupture
Immediate contiguous (above) sagittal CT with contrast of the pelvis shows on the immediate image fluid and air anterior to the bladder (above left) and air anteriorly in the fluid-filled vagina and active bleeding in the rectum posteriorly (above right). The delayed image (below) shows extravasated intravenous contrast anterior to the contrast filled bladder.