Normal anal variation in preschool children selected for none-abuse

Studies on clinical samples have indicated that approximately 30% of sexually abused children are reporting anal sexual abuse. Different anal findings are described in the literature as more or less associated with trauma against the anal area. We are conducting a study with the aim of describing the normal variation in anogenital anatomy and microbiology in young children, as well as comparing different examination positions. 300 preschool children with no history of sexual abuse will be recruited. This preliminary report presents data on anal anatomy in 103 boys with a mean age of 5,48 years. Erythema was seen in 12 boys, increased pigmentation in 15 boys, and irregular rugae pattern in 4 boys. Venous congestion was seen in 18 boys examined in knee chest position. 40 boys had midline structures in left side position and 67 in knee-chest position. 2 boys had isolated findings outside the midline. One child had a condyloma localized in the perineum, and 6 children had some form of anal dilatation in knee chest position. Our preliminary conclusion is that a number of none-abused boys have anatomical findings, which also can be seen in sexually abused children. Further more, an important finding is that the prone knee-chest examination position displays significant more anatomical details compared with the left side position.