Your 5-year-old male patient has an absent anal reflex along with anorectal tears and ecchymosis,which are most likely caused by

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The following are possible signs of sexual abuse in children: a)a strong fear of the physical exam; b)presence of STDs; c)abnormal discharge or odor; d)anorectal tears; e)absent or delayed anal reflex; f)anorectal ecchymosis,pruritus,scarring,HPV,or bleeding; f)in the female child,a broken hymen,or vaginal tears.An absent anal reflex without the anorectal tears and ecchymosis are caused by conditions such as a spinal cord lesion and tumors that interrupt nervous innervation to the anal sphincter.

Your 5-Year-Old Male Patient Has an Absent Anal Reflex Along