Mortality due to pelvic inflammatory disease with peritonitis with surgical intervention occurring in a sexually abused minor: A case report

Abstract

Introduction: Pediatric sexual abuse is generally under reported. Complications of abuse include physical injuries and infections that may result in mortality. These are likely to be managed by health care professionals who are inexperienced in the diagnosis of gender-based violence such as surgeons. In fatal cases, the primary diagnosis may be established at autopsy. There are no reports of autopsies that describe infectious and complications of pediatric sexual abuse. Objective: To present an autopsy case of pediatric infectious post-surgical mortality due to sexual abuse. Case report: We present a case of pre-pubertal sexual abuse that presented as fatal pelvic inflammatory disease and peritonitis, whose diagnosis was incidentally made at autopsy. She had undergone surgery for management of peritonitis which was unsuccessful. The immediate cause of death was acute lung injury. Severe abdomino-pelvic peritonitis with pelvic inflammatory disease was found on autopsy. Laboratory analysis suggested infection by Neisseria gonorrhoeae. Conclusion: Pediatric sexual assault can cause surgically relevant peritoneal disease. A high index of suspicion is essential for their diagnosis. Keywords: Pediatric sexual abuse, Peritonitis, Pelvic inflammatory disease, Abdominal surgery