Topical Tranexamic Acid to Control Vaginal Laceration Bleeding after Sexual Assault

Background: Sexual assault survivors may sustain vaginal trauma that requires intervention in the emergency department, or operating room. Case Report: We describe the case of a 16-year-old female who was referred to the emergency department for evaluation of continued bleeding from a vaginal laceration following sexual assault 38 h prior. The bleeding limited the medical forensic medical examination, but she was hemodynamically stable. After the application of tranexamic acid (TXA)-soaked gauze, the patient's bleeding was controlled and the wound was able to be evaluated and the examination completed. Why Should an Emergency Physician Be Aware of This?: To our knowledge, this is the first case in the literature that describes the use of topical TXA in a patient to achieve hemostasis in a vaginal laceration sustained from sexual violence.