We present the case of an 11-year-old girl who presented as a surgical emergency with acute abdominal pain. [sciencerepository.org]

Presented are two cases of imperforate hymen with hematocolpos seen in a pediatric emergency department (ED) during a seven-month period. The first case presented with abdominal pain, urinary obstruction, and constipation on initial visit. [ncbi.nlm.nih.gov]

Our patient had a history of irregular periods since her menarche 9 months before presentation, as well as a history of daily bleeding for 3 months. This presentation initially did not lead to the consideration of a diagnosis of hematocolpos. [consultant360.com]

She presented to her primary care physician for evaluation. [primescholars.com]

At clinical examination, secondary sexual characteristics were present and within normal ranges. [hindawi.com]

• Intermittent Fever

  She also had had intermittent fever as high as 38.9°C. There was no history of vomiting, diarrhea, or constipation. Her last menstrual period had lasted for 3 months and had ended 3 days before presentation. [consultant360.com]

• Perineal Pain

  Hematocolpos should be on the list of differential diagnoses in adolescent girls with primary amenorrhea who present with any of the following: cyclic recurrent abdominal pain; persistent lower abdominal and back pain; perineal pain and pressure; symptoms [consultant360.com]

• Costovertebral Angle Tenderness

  She had no costovertebral angle tenderness. Laboratory tests revealed a white blood cell (WBC) count of 6,800/µL, a hemoglobin level of 11.3 g/dL, and a platelet count of 298 × 103/µL. [consultant360.com]

• Imperforate Hymen

  Hematocolpos secondary to imperforate hymen. [intjem.biomedcentral.com]

  K E Y W O R D S Imperforate hymen Hematocolpos Adolescent emergencies Introduction Imperforate hymen is a rare condition, resulting when the hymen, a thin membrane at the junction of the sinovaginal bulb and urogenital sinus, fails to perforate during [sciencerepository.org]

  Record: found Abstract: found Article: not found [Imperforate hymen: one diagnosis can hide another]. A case of imperforate hymen discovered after a surgical complication is reported. [scienceopen.com]

  A rare cause of this condition is hematocolpos due to imperforate hymen. Case. [hindawi.com]

  Reference article, Radiopaedia.org (Accessed on 25 Nov 2022) https://doi.org/10.53347/rID-14660 Hematocolpos is a term given to a blood-filled dilated vagina due to menstrual blood in the setting of an anatomical obstruction, usually an imperforate hymen [radiopaedia.org]

• Amenorrhea

  The most common cause of hematocolpos is an imperforate hymen, which is associated with primary amenorrhea. Primary amenorrhea also is present when hematocolpos is caused by a complete transverse vaginal septum, vaginal agenesis, or vaginal atresia. [consultant360.com]

  Hypothalamic amenorrhea is typically characterized by amenorrhea in the absence of anatomic, chromosomal or organic abnormalities. Often a diagnosis of exclusion, it is one of the most common causes of secondary amenorrhea [7]. [file.scirp.org]

  Patients may present with amenorrhea or vague abdominal pain. [radiopaedia.org]

  While unusual, this case demonstrates that hematocolpos should be considered in patients with a history of epidermal bullous disease and amenorrhea. [ncbi.nlm.nih.gov]

  Keywords : hematocolpos; imperforate hymen; primary amenorrhea. [scielo.mec.pt]

• Primary Amenorrhea

  The most common cause of hematocolpos is an imperforate hymen, which is associated with primary amenorrhea. Primary amenorrhea also is present when hematocolpos is caused by a complete transverse vaginal septum, vaginal agenesis, or vaginal atresia. [consultant360.com]

  Keywords : hematocolpos; imperforate hymen; primary amenorrhea. [scielo.mec.pt]

  Saks, E.K., Vakili, B. and Steinberg, A.C. (2009) Primary amenorrhea with an abdominal mass at the umbilicus. [file.scirp.org]

• Enlarged Uterus

  Pelvic MRI showed an enlarged uterus measuring 10.8 cm × 3.9 cm × 5.4 cm without any focal uterine masses. [primescholars.com]

  Transabdominal POCUS showed a distended vaginal canal, markedly enlarged uterus, and moderate hydronephrosis bilaterally (Video). Renal function was normal on a chemistry panel. She was diagnosed with hematometrocolpos, and gynecology was consulted. [westjem.com]

  With ultrasound the uterus can be seen as an enlarged pelvic mass with an echo free lumen due to the presence of blood [14]. [medcraveonline.com]

• Delayed Menarche

  The diagnosis is usually delayed till after puberty when it presents with its complications like delayed menarche, cyclic lower abdominal pain and mass, and bulging vaginal membrane as in miss UG [ 2 ]. [omicsonline.org]

  menarche often Hematometra is a related condition in which the uterus fills with menstrual blood. [nursespost.com]

2010 International Journal of Emergency Medicine volume 3, pages 481–482 (2010)Cite this article 2469 Accesses 7 Citations 17 Altmetric Metrics details A previously healthy 12-year-old female was sent to the Emergency Department by her pediatrician for workup [intjem.biomedcentral.com]

A previously healthy 12-year-old female was sent to the Emergency Department by her pediatrician for workup of severe suprapubic abdominal pain radiating to her lower back. [ncbi.nlm.nih.gov]

Hymenotomy is the treatment of hematocolpos by hymenal imperforation. For hematocolpos revealing malformations, the treatment of the causal malformation is more complex. [peertechzpublications.com]

However, this patient developed an obstruction due to lack of prophylactic treatment. [primescholars.com]

Even when the condition is properly diagnosed, the results of treatment are often unsatisfactory. In the University Hospital one death followed treatment. [jamanetwork.com]

Discussion Early diagnosis and timed surgical treatment of an imperforate hymen are important to prevent the complications associated with the delayed treatment after puberty. [omicsonline.org]

On the other hand, its lack of knowledge exposes it to serious complications, threatening its vital prognosis and seriously compromising its obstetrical future. [peertechzpublications.com]

Outcome and Prognosis Clinical outcome and prognosis generally are good; one study found pregnancy success more likely following surgical correction of an imperforate hymen than following repair of a complete transverse septum. [34] The retrograde menses [emedicine.medscape.com]

Patient and her parents were counseled about poor prognosis in view of cervical stenosis and were asked to follow up as the definitive plan in this case was hysterectomy. [jpgo.org]

Hematometra and Hematocolpos Synonyms/Description Hydrometra and hydrocolpos Pyometra and pyocolpos Etiology The most common etiology is cervical or vaginal obstruction, resulting in a collection of blood, pus, or fluid that distends the uterus or vagina [clinicalgate.com]

DOI: https://doi.org/10.20344/amp.11912 Keywords: Adolescent, Hematocolpos, Hymen, Urinary Retention/etiology Abstract Hematocolpos is an obstruction of the menstrual flow due to an anomaly of the genital tract, with imperforate hymen being the most common [actamedicaportuguesa.com]

On evaluation, the goal is to differentiate an imperforate hymen from other obstructing anatomic etiologies, such as labial adhesions, urogenital sinus, transverse vaginal septum, or distal vaginal atresia. [m.acog.org]

Spectrum of etiologies causing hydrometrocolpos. J Neonatal Surg 2013; 2(1): 5. Google Scholar | Medline 12. Garcia Rodriguez, R, Perez Gonzalez, J, Garcia Delgado, R. [journals.sagepub.com]

Similarly, in case of infectious etiology, the vaginal drainage decreased risk of peritonitis which could have resulted from abdominal approach. [primescholars.com]

Journal Journal ID (nlm-ta): Pan Afr Med J Journal ID (iso-abbrev): Pan Afr Med J Journal ID (publisher-id): PAMJ Title: The Pan African Medical Journal Publisher: The African Field Epidemiology Network ISSN (Electronic): 1937-8688 Publication date (Electronic [scienceopen.com]

Pathophysiology The cause of Hematocolpos can vary, but almost exclusively involves physical obstruction of the reproductive tract, leading to a backup of menstrual blood which accumulates proximal to the obstruction. [nursespost.com]

Golden, N.H. and Carlson, J.L. (2008) The pathophysiology of amenorrhea in the adolescent. [file.scirp.org]

^ "Vaginal Atresia: Background, Anatomy, Pathophysiology". 2019-07-03. ^ "Transverse Vaginal Septum | Boston Children's Hospital". www.childrenshospital.org. Retrieved 2019-09-21. External links[edit] [en.wikipedia.org]

^ "Vaginal Atresia: Background, Anatomy, Pathophysiology". 2019-07-03. ^ "Transverse Vaginal Septum | Boston Children's Hospital". www.childrenshospital.org. [wikizero.com]

After surgical evaluation and drainage of hematocolpos via incision and drainage, a foley balloon was placed to prevent re-epithelialization. Intra-operative fluid cultures yielded no growth. [primescholars.com]

Ideally, diagnosis should be made early during fetal and neonatal examinations to prevent symptomatic presentations of its complications at puberty. [omicsonline.org]

This fatality led to a review of the subject in the hope that another such occurrence might be prevented. [jamanetwork.com]