ABSTRACT
A 4-year-old girl presents to the emergency department with vaginal bleeding. She is urinating normally without pain, but there is blood on the toilet paper. There is no history of vomiting, diarrhea, abdominal pain, or change in her bowel habits. Her appetite has been normal. She has been well without fever or ill contacts. There is no history of trauma. The family does not have any concerns for sexual abuse.
