Riferita violenza sessuale: Il ruolo ginecologo nel Pronto Soccorso

Alleged sexual assault. The role of the Emergency department gynecologist. The objective of this paper is to better understand the role of the Emergency department gynecologist in cases of alleged sexual assault. The gynecologist should know that he is a justice collaborator and, as public officer, he has to report to authorities every indictable offence. He should also know that patient's informed consent is required during each step of medical investigation. The doctor should indeed know when, how and where to find and collect evidence of crime and perform, in conformity with the victim's statement, specimens of biologic samples, a pregnancy test and a prophylaxis of sexually trasmitted diseases. The gynecologist should evaluate psychological and general state of the patient, take the tailored medical history including the modalities of violent act, perform a physical examination, a genital and rectal examination with accurate description of the lesions and collect evidence of rape. The role of the gynecologist is to document all injuries in order to afterwards establish the conformity with patient's history. He should treat acute physical injuries, offer the counseling for the prevention of sexually trasmitted diseases, for the pregnancy prophylaxis and emergency contracception and for psycosocial consequences, report to authorities as required by law and, at last, arrange for follow-up medical care and counseling. Personal experience highlights the necessity of a standard protocol to be used in all Emergency departments. This would allow and facilitate an uniform medical approach to the sexual assault victim as well as an accurate and correct collection of data for legal requirements.