Misdiagnosis of a primary vaginal stone leading to a suspicion of sexual assault in a heavily disabled woman

Abstract A 26-year-old heavily disabled woman was admitted through the emergency department after presenting signs of respiratory distress. A pear-shaped object present in the vagina was discovered unexpectedly on a full-body CT-scan. Sexual assault was suspected and the case was subsequently reported to the authorities. The office of the forensic medical examiner was notified to further investigate the case. The vaginal object of unknown origin was sent to the pathology department, where it was identified as being a primary vaginal stone and the hypothesis of a sexual assault could be excluded. The aim of this case report is to raise awareness amongst clinicians and forensic medical examiners about the existence of vaginal stones, especially in female patients suffering from disabilities, incontinence and recurrent infections of the pelvic area. The presence of a foreign body can be suspicious of sexual assault in certain settings, but physicians as well as medical examiners need to be careful while interpreting lesions in order to protect patients from unnecessary investigations that can be traumatic such as sexual assault kits.