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Hematocolpos


Presentation

  • Abstract 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]
  • An analysis is presented of the salient embryologic, clinical, and radiologic features of the 41 cases gathered.[ncbi.nlm.nih.gov]
  • We present a case of 14-year-old female who initially presented with an abdominal pain and was found to have fluid filled uterine horn on the abdominal ultrasound.[sages.org]
  • Here, we present a case of LeFort colpocleisis in which excessive anticoagulation led to an infected hematocolpos and persistent bleeding. This was successfully managed with a Bakri balloon via a vaginal channel without recurrence of her prolapse.[ncbi.nlm.nih.gov]
  • We recommend the limited use of vaginal biopsies in the face of a typical vaginitis presentation, and aggressive treatment to promote mucosa healing when biopsies are required.[ncbi.nlm.nih.gov]
Asymptomatic
  • Abstract The malformative syndrome of double vagina in association with uterus didelphus and kidney agenesis is a rare condition, often asymptomatic: if this condition is accompanied by imperforated obstructed hemivagina, the clinical manifestations depend[ncbi.nlm.nih.gov]
  • Both patients were asymptomatic, and were regularly followed up at an outpatient clinic. To date, the hematocolpos persists but continues to be small.[ncbi.nlm.nih.gov]
  • The condition was initially asymptomatic, resolved spontaneously at first and recurred.[ncbi.nlm.nih.gov]
  • Asymptomatic in the follow-up, one month later. Conclusion : The diagnosis of imperforate hymen and hematocolpos is probable in an adolescent girl with primary amenorrhea, abdominal pain or acute urinary retention.[scielo.mec.pt]
Weakness
  • OBJECTIVE: To document the occurrence of hematocolpos causing sciatica and leg weakness in an adolescent girl.[ncbi.nlm.nih.gov]
  • To document the occurrence of hematocolpos causing sciatica and leg weakness in an adolescent girl. Low back pain resulting from hematocolpos has been reported previously but not associated with symptoms of sciatica or neurologic weakness.[journals.lww.com]
  • […] uterine rupture子宮破裂 uterus子宮 v vacuum extraction delivery (VE)吸引分娩 vagina膣 vaginal birth自然分娩、経膣分娩 vaginitis膣炎 variable deceleration変動性一過性徐脈 vulva外陰 vulvar cancer外陰癌 vulvar intraepithelial neoplasia外陰上皮内腫瘍 vulvar pruritus外陰掻痒症 vulvitis外陰炎 vulvodynia外陰疼痛 w weak[tokyo-med.ac.jp]
Pelvic Mass
  • All had large pelvic masses with greater than 400 ml of old blood being drained at hymenotomy in all patients. Irritation of the sacral plexus or nerve roots is postulated as a mechanism for the referred back pain.[ncbi.nlm.nih.gov]
  • The embryogenesis of müllerian duct abnormalities, associated clinical findings, including abdominal tenderness and pelvic mass, diagnostic modalities of cystoscopy, excretory urography, laparoscopy and hysterosalpinography are discussed.[ncbi.nlm.nih.gov]
  • Invariably this complex of anomalies is seen in adolescents and young women with progressively severe abdominal pain, menstrual irregularities, and a pelvic mass.[ncbi.nlm.nih.gov]
  • It presents after puberty as primary amenorrhoea, recurrent pelvic pain with a pelvic mass. This can be caused by a congenital stenosis of the cervix, or by a complication of a surgical treatment.[en.wikipedia.org]
  • Abdominal ultrasonography revealed a large pelvic mass of uncertain origin. The uterus could not be identified ultrasonographically.[anatomybox.com]
Diarrhea
  • Open Access Clinical Images First Online: 06 May 2010 Keywords Emergency Department Diarrhea Abdominal Pain Urinary Retention Ultrasound Examination These keywords were added by machine and not by the authors.[doi.org]
  • The patient denied nausea, vomiting, and diarrhea, but reported mild urinary retention. Per history she was premenarchal. Her vital signs were heart rate (HR), 83; blood pressure, 129/85 mmHg; temperature, 36.1 ºC.[ncbi.nlm.nih.gov]
  • 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. She had been using 1 or 2 light pads each day for these 3 months.[consultant360.com]
Nausea
  • The patient denied nausea, vomiting, and diarrhea, but reported mild urinary retention. Per history she was premenarchal. Her vital signs were heart rate (HR), 83; blood pressure, 129/85 mmHg; temperature, 36.1 ºC.[doi.org]
Severe Abdominal Pain
  • Invariably this complex of anomalies is seen in adolescents and young women with progressively severe abdominal pain, menstrual irregularities, and a pelvic mass.[ncbi.nlm.nih.gov]
  • The girl complained of severe abdominal pain, which appeared with each of her menses. INTERVENTION(S): The intervention was performed by a vaginoscopic approach to preserve the integrity of the hymen.[ncbi.nlm.nih.gov]
Abdominal Bloating
  • On and off lower abdominal pain lasting more than a week Pain with cramping, with episodes of worse pain in between Vomiting without blood or bile Abdominal bloating and distention Constipation and changes in urine output Tender breasts Vaginal bleeding[en.wikipedia.org]
  • bloating and distention [11] Constipation and changes in urine output [11] Tender breasts [11] Vaginal bleeding or discharge [11] Causes There can be four possible causes of hematocolpos [12] Imperforate hymen Cervical atresia Vaginal atresia Transverse[thereaderwiki.com]
Irritability
  • Irritation of the sacral plexus or nerve roots is postulated as a mechanism for the referred back pain. Hematocolpos should be included in the differential diagnosis of prepubertal girls who have low back pain.[ncbi.nlm.nih.gov]
  • Irritation of the sacral plexus or nerve roots is postulated as a mechanism for the referred back pain. Hematocolpos should be included in the differential diagnosis of prepubertal girls who have low back pain . Lippincott-Raven Publishers.[journals.lww.com]
Sciatica
  • OBJECTIVE: To document the occurrence of hematocolpos causing sciatica and leg weakness in an adolescent girl.[ncbi.nlm.nih.gov]
  • To document the occurrence of hematocolpos causing sciatica and leg weakness in an adolescent girl. Low back pain resulting from hematocolpos has been reported previously but not associated with symptoms of sciatica or neurologic weakness.[journals.lww.com]
Imperforate Hymen
  • Most common cause of hematocolpos (LQ) A cervical atresia B vaginal atresia C transverse vaginal septum D imperforate hymen Ans. D imperforate hymen I. Hematocolpos is collection of blood in the vagina. II.[gradestack.com]
  • A genitourinary exam revealed an imperforate hymen. A diagnosis of hematocolpos secondary to imperforate hymen was made and surgically confirmed.[doi.org]
  • Mucometrocolpos is the accumulation of mucous secretions behind an imperforate hymen. Mucometrocolpos can sometimes cause abdominal distention.[en.wikipedia.org]
  • Ultrasound and subsequent surgery confirmed the physical findings in the ED of imperforate hymen and hematocolpos. Both patients underwent hymenectomy, and they have experienced no further symptoms.[ncbi.nlm.nih.gov]
  • The syndrome known as imperforate hymen with hematocolpos has been recognized for centuries and yet is seldom diagnosed by the physician who first sees the patient.[doi.org]
Amenorrhea
  • 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]
  • More than 300 years ago Ambroise Paré described a case in which, because of amenorrhea, pain and abdominal swelling, the condition was diagnosed as pregnancy.[doi.org]
  • 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]
  • Common symptoms associated with this disorder include amenorrhea or dysmenorrhea in premenopausal women, pelvic pain or pressure, urinary frequency and retention.[medcrave.com]
  • Conclusion : The diagnosis of imperforate hymen and hematocolpos is probable in an adolescent girl with primary amenorrhea, abdominal pain or acute urinary retention.[scielo.mec.pt]
Primary Amenorrhea
  • Conclusion : The diagnosis of imperforate hymen and hematocolpos is probable in an adolescent girl with primary amenorrhea, abdominal pain or acute urinary retention.[scielo.mec.pt]
  • Primary amenorrhea and cyclical lower abdominal pain are the chief presenting complaints of hematocolpos . A specific association of uterus didelphys, unilateral hematocolpos and ipsilateral renal agenesis has been described.[diki.pl]
  • Saks, E.K., Vakili, B. and Steinberg, A.C. (2009) Primary amenorrhea with an abdominal mass at the umbilicus.[file.scirp.org]
  • 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]
Primary Amenorrhea
  • Conclusion : The diagnosis of imperforate hymen and hematocolpos is probable in an adolescent girl with primary amenorrhea, abdominal pain or acute urinary retention.[scielo.mec.pt]
  • Primary amenorrhea and cyclical lower abdominal pain are the chief presenting complaints of hematocolpos . A specific association of uterus didelphys, unilateral hematocolpos and ipsilateral renal agenesis has been described.[diki.pl]
  • Saks, E.K., Vakili, B. and Steinberg, A.C. (2009) Primary amenorrhea with an abdominal mass at the umbilicus.[file.scirp.org]
  • 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]
Delayed Menarche
  • Case report: We report a case of a 15-year-old girl who presented with delayed menarche, eight-month history of cyclic abdominal pain, and a three-week history of lower abdominal swelling.[omicsonline.org]
  • menarche often Hematometra is a related condition in which the uterus fills with menstrual blood.[nursespost.com]

Workup

  • 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.[doi.org]
Ovarian Mass
  • It is important to make an early accurate diagnosis since they are usually managed as having an ovarian mass and submitted to multiple laparotomies and occasionally to mutilating surgery.[ncbi.nlm.nih.gov]

Treatment

  • Even when the condition is properly diagnosed, the results of treatment are often unsatisfactory. In the University Hospital one death followed treatment.[doi.org]
  • All patients underwent vaginal conservative surgical treatment (excision of vaginal septum) /- radical treatment: hemi- colpohysterectomy in case of failure of conservative treatment.[ncbi.nlm.nih.gov]
  • We recommend the limited use of vaginal biopsies in the face of a typical vaginitis presentation, and aggressive treatment to promote mucosa healing when biopsies are required.[ncbi.nlm.nih.gov]
  • Early accurate diagnosis and treatment will decrease morbidity and unnecessary surgical procedures.[ncbi.nlm.nih.gov]
  • In 1 girl blunt lysis of the adhesions was performed with the patient under general anesthesia, followed thereafter by local hydrocortisone and estriol treatment.[ncbi.nlm.nih.gov]

Prognosis

  • 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]

Etiology

  • 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]
  • Clinicians must be aware of atypical presentations and potential multifactorial etiologies of amenorrhea. Ensuring a thorough evaluation is essential in order to mitigate long-term effects of a misdiagnosis.[file.scirp.org]

Pathophysiology

  • 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]

Prevention

  • This fatality led to a review of the subject in the hope that another such occurrence might be prevented.[doi.org]
  • Findings concerning a genital tract outflow obstruction in a young female are generally treated without delay to prevent future reproductive problems.[ncbi.nlm.nih.gov]
  • Ideally, diagnosis should be made early during fetal and neonatal examinations to prevent symptomatic presentations of its complications at puberty.[omicsonline.org]

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