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Child sexual abuse is an important and not uncommon problem. Children who have been sexually abused may present to a physician's office, urgent care centre, or emergency department for medical evaluation. A medical evaluation can provide reassurance to both child and caregiver, identify care needs, and offer an accurate interpretation of findings to the justice and child welfare systems involved. Given the potential medico-legal implications of these assessments, the performance of a comprehensive evaluation requires both current knowledge and clinical proficiency. This position statement presents an evidence-based, trauma-informed approach to the medical evaluation of prepubertal children with suspected or confirmed sexual abuse., (© Canadian Paediatric Society 2020. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Thrombomodulin (TM) is the endothelial cofactor of the anticoagulant protein C system. The distribution of TM in the organism was studied in the rabbit using a goat anti TM, affinity-purified antibody and a peroxidase-labelled antigoat immunoglobulin. TM antigen was found on the endothelial surface of all blood vessels: capillaries, arteries and veins. The reaction was specific: connective tissue, smooth and striated muscle bone, cartilage, nerve tissue, secretary epithelia and all parenchyma studied were not strained. Moreover TM antigen was present on the surface of serosa: peritoneum, pericardium and pleura as well as on synovial membranes and on arachnoid, all along the central nervous system. It was absent from pia and dura mater. The antigen was found only after formalin fixation on the vessels and body cavities surface on which it lies. This observation shows that the antigen is easily detached from these surfaces and suggest a possible mobility of this endothelial molecule for which it lies. This observation shows that the antigen is easily detached from these surfaces and suggest a possible mobility of this endothelial molecule for which production and function sites might differ.