Background: Sexual abuse often is the primary diagnosis considered when prepubertal girls present with vaginal trauma. Although sexual abuse is very concerning and should remain high in the differential diagnosis, a variety of accidental injuries also can cause genital injury.
Case: A 5-year-old girl presented to the emergency department with genital bleeding after a vehicle rolled over her pelvis. She had isolated vaginal lacerations on exam.
Summary and conclusion: Extreme pelvic compression is an adequate mechanism of injury in a child presenting with vaginal laceration.