Normal anal variation in pre-school 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 have conducted 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. 306 pre-school children with no history of sexual abuse are recruited. This report presents data on anal anatomy in 103 boys and 203 girls in the age group 5 and 6 years. The number of findings like erythema, venous congestion, condyloma, irregular anal folds, anal dilatation, fissures and abrasions will be described. Midline structures like skin tags, smooth areas, depressions and median raphe will be discussed. Our preliminary conclusion is that a number of none-abused ch ildren have anatomical findings, which also can be seen in sexually abused children. Further more, an important finding is that the pron e knee-chest examination position seems to display more anatomi cal details compared with the left side position.