Anal bruising caused by child abuse. Close-up of the severely bruised anus of a baby girl. This bruising has been caused by abuse: in this case, a form of anal rape is the most likely cause. Abuse such as this may be a manifestation of paedophilia, the use of children for sexual gratification. In most cases, sexual abuse of children is performed by a male parent, guardian or family friend of the abused child. If a child is found to be at risk of abuse in the home, they may be taken into residential care. Counselling may be required to counter any psychological and emotional effects.