Abstract
Vaginal foreign bodies in children are uncommon, with curiosity being the most frequently reported cause. The study reports the case of a 5-year-old girl who presented to Al-Zahra Hospital with abdominal pain and vaginal discharge. Radiography confirmed the presence of a metallic bead within the vagina. Then, the foreign body was successfully and gently removed under anesthesia in the operating room. While rare, vaginal foreign bodies in children can be diagnostically challenging. Only 10% of patients present with a direct complaint; the remainder exhibit non-specific symptoms such as malodorous discharge, vaginal bleeding, or pelvic pain. The peak age for presentation is around 6 years, linked to exploratory behaviors. A bimodal age distribution (6-7 years and 21-22 years) has also been noted. The most commonly found objects include tissue paper, batteries (the most dangerous due to their potential to cause chemical burns), coins, hairpins, and beads. Diagnostic modalities include ultrasound, radiography, or vaginoscopy, which is considered the gold standard. Standard treatment involves the removal of the foreign body under anesthesia in an operating room setting. Importantly, the possibility of sexual abuse should always be investigated.
Practical Implications. In prepubertal girls presenting with non-specific symptoms such as foul-smelling vaginal discharge, vaginal bleeding, or pelvic/abdominal pain, a vaginal foreign body should be considered an important differential diagnosis, and a structured assessment for possible sexual abuse should be undertaken systematically.