Curr Pediatr Res 2017; 21 (S1): 5-9 ISSN 0971-9032 www.currentpediatrics.com Curr Pediatr Res 2017 Volume 21 Issue S1 5 Introduction The mistreatment and abuse of minors include all forms of physical and/or emotional mistreatment, sexual abuse, neglect, lack of care, or exploitation (commercial or otherwise) that causes harm to a child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power [1-3]. According to a study conducted by Terre des homes and CISMAI (Coordinated Italian Services against Infant Mistreatment or Abuse) in 2012-2013, 6.36% of all the children surveyed in the area in question have been assisted by social services and that 0.98% of those had been subject to abuse. In other words, 1 in every 6 children assisted by social services and 1 in every 100 children in the entire surveyed area were victims of abuse. Abuse therefore represents a primary cause in the intervention of social services, constituting 15.46% of all children assisted by social services. The consequences of abuse are both physical and psychological: dificulty in physical growth and language learning, intellectual deicits, dificulty at school, running away from home, use and selling of drugs, destructive behavior both towards themselves and others, and suicide attempts to name but a few [4,5]. A comment on the impact of different forms of child abuse Sexual violence is a problem that covers many dimensions, each of which having speciic and unique requirements and neither of which taking precedence over the other [6-8]. Speciically, a case of abuse raises two different questions: the irst of which asks whether a problem does in fact exist, and how can it be resolved. The second, instead, poses a different question: does a guilty party exist, and who is it? The irst question therefore concerns the area of care, within which a medical visit would aim to acquire diagnostic elements to establish whether abuse was present. Instead, the second question concerns a more judiciary approach in which the true/false categories cannot be overlooked. In this case, the visit becomes a means of constructing a narrative that builds an image of the process and its roots during primary evaluations [9]. The medical diagnosis was for a long time substantially the prerogative of forensic disciplines and has only recently assumed a more general medical and assistive character. In this regard, differential diagnosis with other conditions which may cause vaginal and/or anal bleeding, such as endometriosis [10-14], endocrinological diseases and hormonal dysbalance [15-22] and cancer [23-29], although uncommon, should be carefully taken into account. This has given the diagnosis of abuse or violence a more medical meaning, in the sense that it has become the prerequisite in commencing treatment [30,31]. However, the dificulty that medical practitioners face when recognising the signs of physical and psychological abuse still lurks in the shadows surrounding this particular subject. There has long been a A multidisciplinary approach in cases of child abuse: The key role of gynaecologist, pediatrician and psychologist. Angelo Montana 1 , Michele Fichera 2 , Pierluigi Giampaolino 3 , Calogero Salvaggio 4 , Antonella D’Apolito 3 , Fabrizia Santangelo 3 , Mariateresa Musone 3 , Agnese Maria Chiara Rapisarda 2 , Federica Di Guardo 2 , Valentina Lucia La Rosa 5 , Marco Panella 2 1 Laboratory of Forensic Toxicology, Department "G.F. Ingrassia", University of Catania, Catania, Italy. 2 Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy. 3 Department of Public Health, School of Medicine, University of Naples "Federico II", Naples, Italy. 4 Azienda Sanitaria Provinciale 2 Caltanissetta, “Sant'Elia” Hospital, Caltanissetta, Italy. 5 Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy. The aim of this work is to propose a comment on the impact of different forms of child abuse. A multidisciplinary approach (gynecological, psychological and pediatric) is important for an adequate diagnosis and an early recognition of the abuse in order to minimize the serious impact of child abuse on the physical and psychological wellbeing of the victims. Abstract Keywords: Child abuse, Diagnosis, Gynaecologist, Pediatrician, Psychologist. Accepted October 27, 2017