Objective: The present study was aimed to evaluate the cases presented with sexual abuse claims referred by judicial authorities for forensic examination. Material and Methods: The reports on cases presented to the Fırat University Faculty of Medicine Forensic Medicine Department Polyclinic with sexual abuse claims between 2016 and 2020 were reviewed retrospectively. The cases were evaluated in terms of sociodemographic features and examination results. Results: Of the cases, 128 (82.6%) were female. 64.8% of the women presented with vaginal penetration, and that the suspect was most frequently a friend or partner of the victim (38.2%), where 64 (41.3%) victims applied within the first 3 days following the incident. Upon genital examinations, the hymens in question were mostly in annular form (89.1%), 52.8% of the female cases were hymen injury, the natural notches were most frequently at the 3 and 9 o'clock locations (15.9%) in the lithotomy position, and that the tears were the most common at the 6 o'clock location (29.4%). 5.2% of all the cases had anal penetration, and that 75% of the acute hymen tears and all the acute anal penetration were examination was found within first three days. Conclusion: It is known that the detecting criminal manifestations becomes more challenging as the application is delayed following the sexual abuse incident. For this reason, we believe that it is important to determine the reasons for the delay in reporting the crime of the victims and to take the necessary precautions, in order to collect the findings of the crime properly and to get the punishment they deserve.
Keywords: Sexual assault; abuse; forensic medicine
Amaç: Bu çalışmada cinsel istismar iddiası nedeniyle adli makamlar tarafından adli muayene istemi ile başvuran olguların değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Fırat Üniversitesi Tıp Fakültesi Adli Tıp AD Polikliniğine, 2016-2020 yılları arasında cinsel istismar iddiası nedeniyle başvuran olguların raporları retrospektif olarak incelendi. Olgular, sosyodemografik özellikler ve muayene bulguları açısından değerlendirildi. Bulgular: Başvuran olguların 128'i (%82,6) kadındı. Kadınların %64,8'inin vajinal yolla penetrasyon iddiası ile geldiği, şüphelinin en sık mağdurun arkadaşı veya partneri (%38,2) olduğu, mağdurların 64'ünün (%41,3) olay sonrası ilk 3 gün içerisinde başvurduğu saptandı. Yapılan genital muayenelerde değerlendirilen himenlerin sıklıkla (%89,1) halkavi (anüler) yapıda olduğu, kadın olguların %52,8'inin himende yaralanma olduğu, doğal çentiklerin litotomi pozisyonunda saat kadranı hesabıyla en sık 3 ve 9 hizalarında (%15,9), yırtıkların ise en sık 6 hizasında (%29,4) olduğu görüldü. Tüm olguların %5,2'sinde anal penetrasyon bulgularının mevcut olduğu, akut himen yırtıklarının %75'inin, anal yolla penetrasyon akut bulgularının ise tamamının ilk 3 gün içerisinde muayeneye geldiği tespit edildi. Sonuç: Cinsel istismar olayı sonrası başvuru süresi uzadıkça suç bulgularının tespitinin güçleştiği bilinmektedir. Bu nedenle mağdurların suç bildiriminde gecikme nedenlerinin belirlenerek gereken önlemlerin alınmasının, suça ait bulguların uygun şekilde toplanabilmesi ve suçluların hak ettiği cezayı alabilmesi açısından önemli olduğu kanaatindeyiz.
Anahtar Kelimeler: Cinsel saldırı; istismar; adli tıp
- Leder MR. Acute sexual assault and evidence collection in the DNA era. Clin Pediatr Emerg Med. 2012;13(3):194-201. [Crossref]
- Welch J, Mason F. Rape and sexual assault. BMJ. 2007;334(7604):1154-8. [Crossref] [PubMed] [PMC]
- Smith SG, Zhang X, Basile KC, Merrick MT, Wang J, Kresnnow M, et al. The National Intimate Partner and Sexual Violence Survey : 2015 Data Brief-Updated Release. 2018. Cited: September 5, 2021. Avaialable from: [Link]
- World Health Organization. Guidelines for medico-legal care for victims of sexual violence. Geneva: World Health Organization; 2003. [Link]
- Luce H, Schrager S, Gilchrist V. Sexual assault of women. Am Fam Physician. 2010; 81(4):489-95. [PubMed]
- Schei B, Sidenius K, Lundvall L, Ottesen GL. Adult victims of sexual assault: acute medical response and police reporting among women consulting a center for victims of sexual assault. Acta Obstet Gynecol Scand. 2003;82(8): 750-5. [Crossref] [PubMed]
- Kolopp M, Delbaere-Crespo E, Lecossec C, Guillet-May F, Coudane H, Martrille L. Examen médicolégal des victimes d'agression sexuelle : caractéristiques et liens avec les suites judiciaires [Forensic examination of sexual assault victims: Medical aspects and associ ations with the legal outcomes]. Gynecol Obstet Fertil Senol. 2017;45(3):158-63. [Crossref] [PubMed]
- Loder RT, Robinson TP. The demographics of patients presenting for sexual assault to US emergency departments. J Forensic Leg Med. 2020;69:101887. [Crossref] [PubMed]
- Maguire W, Goodall E, Moore T. Injury in adult female sexual assault complainants and related factors. Eur J Obstet Gynecol Reprod Biol. 2009;142(2):149-53. [Crossref] [PubMed]
- Rodriguez JJRB, Laude RP, De Ungria MCA. An integrated system for forensic DNA testing of sexual assault cases in the Philippines. Forensic Sci Int Synerg. 2021;3:100133. [Crossref] [PubMed] [PMC]
- Tyagi S, Meshram VP, Sukhadeve RB, Pathak HM, Pandey H. Observational study of victims of alleged sexual assault in central mumbai region. Medico-Legal Updat. 2017;17(1):70. [Crossref]
- Alempijevic D, Savic S, Pavlekic S, Jecmenica D. Severity of injuries among sexual assault victims. J Forensic Leg Med. 2007;14(5):266-9. [Crossref] [PubMed]
- Ben Khelil M, Zgarni A, Belghith M, Allouche M, Banasr A, Bellali M, et al. Managing cases of gender based sexual assault in the Metropole of Tunis, a public health based approach. Aggress Violent Behav. 2019;47:257-61. [Crossref]
- Grossin C, Sibille I, Lorin de la Grandmaison G, Banasr A, Brion F, Durigon M. Analysis of 418 cases of sexual assault. Forensic Sci Int. 2003;131(2-3):125-30. [Crossref] [PubMed]
- Ingemann-Hansen O, Sabroe S, Brink O, Knudsen M, Charles AV. Characteristics of victims and assaults of sexual violence--improving inquiries and prevention. J Forensic Leg Med. 2009;16(4):182-8. [Crossref] [PubMed]
- Zilkens RR, Smith DA, Phillips MA, Mukhtar SA, Semmens JB, Kelly MC. Genital and anal injuries: A cross-sectional Australian study of 1266 women alleging recent sexual assault. Forensic Sci Int. 2017;275:195-202. [Crossref] [PubMed]
- Suttipasit P. Genitoanal injury in sexually assaulted adult women: six-year retrospective in Bangkok. Am J Forensic Med Pathol. 2018; 39(4):312-24. [Crossref] [PubMed]
- Mulder J, Teunissen TAM, Pranger ES, Hiddink-Til A, Lagro-Janssen ALM. Reporting after sexual violence: The influence of victim, assault and perpetrator characteristics. J Forensic Leg Med. 2021;79:102076. [Crossref] [PubMed]
- Trotman GE, Young-Anderson C, Deye KP. Acute sexual assault in the pediatric and adolescent population. J Pediatr Adolesc Gynecol. 2016;29(6):518-26. [Crossref] [PubMed]
- Larsen ML, Hilden M. Male victims of sexual assault; 10 years' experience from a Danish Assault Center. J Forensic Leg Med. 2016; 43:8-11. [Crossref] [PubMed]
- Duchesne S, Seyller M, Chariot P. Male sexual assaults in the Paris, France area: An observational study over 8 years. Forensic Sci Int. 2018;290:16-28. [Crossref] [PubMed]
- Larsen ML, Hilden M, Lidegaard Ø. Sexual assault: a descriptive study of 2500 female victims over a 10-year period. BJOG. 2015; 122(4):577-84. [Crossref] [PubMed]
- McLean I, Roberts SA, White C, Paul S. Female genital injuries resulting from consensual and non-consensual vaginal intercourse. Forensic Sci Int. 2011;204(1-3):27-33. [Crossref] [PubMed]
- Ohayi SR, Ezugwu EC. Prevalence and pattern of genital injuries among adolescent rape victims attending Enugu State University Teaching Hospital, South East Nigeria. J Obstet Gynaecol. 2019;39(2):190-4. [Crossref] [PubMed]
- White C, McLean I. Adolescent complainants of sexual assault; injury patterns in virgin and non-virgin groups. J Clin Forensic Med. 2006;13(4):172-80. [Crossref] [PubMed]
- Feldhaus KM, Houry D, Kaminsky R. Lifetime sexual assault prevalence rates and reporting practices in an emergency department population. Ann Emerg Med. 2000;36(1):23-7. [Crossref] [PubMed]
- Jones JS, Wynn BN, Kroeze B, Dunnuck C, Rossman L. Comparison of sexual assaults by strangers versus known assailants in a community-based population. Am J Emerg Med. 2004;22(6):454-9. [Crossref] [PubMed]
- Yildirim A, Ozer E, Bozkurt H, Ozsoy S, Enginyurt O, Evcuman D, Yilmaz R, Kuyucu YE. Evaluation of social and demographic characteristics of incest cases in a university hospital in Turkey. Med Sci Monit. 2014; 20:693-7. [Crossref] [PubMed] [PMC]
- Sugar NF, Fine DN, Eckert LO. Physical injury after sexual assault: findings of a large case series. Am J Obstet Gynecol. 2004;190(1):71-6. [Crossref] [PubMed]
- Jaiswani AK, Kumar NB, Jaiswani K, Kukde HG, Dere RC. The pattern of genito-anal injuries in female sexual assault cases in Mumbai, India. Forensic Sci Int Reports. 2021;3: 100216. [Crossref]
- Eg MB, Hansen LA, Sabroe S, Charles AV. Hymenal lesions and legal outcome in sexually abused girls with a history of vaginal penetration. Forensic Sci Int. 2015;252:163-7. [Crossref] [PubMed]
- Zilkens RR, Smith DA, Kelly MC, Mukhtar SA, Semmens JB, Phillips MA. Sexual assault and general body injuries: A detailed cross-sectional Australian study of 1163 women. Forensic Sci Int. 2017;279:112-20. [Crossref] [PubMed]
- Kennedy KM. Heterogeneity of existing research relating to sexual violence, sexual assault and rape precludes meta-analysis of injury data. J Forensic Leg Med. 2013;20(5): 447-59. [Crossref] [PubMed]
- Astrup BS, Ravn P, Thomsen JL, Lauritsen J. Patterned genital injury in cases of rape--a case-control study. J Forensic Leg Med. 2013; 20(5):525-9. [Crossref] [PubMed]
.: Process List