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Hematocolpos


Presentation

  • 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 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]
  • 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]
  • One of them presented a very rare onset complaining of acute urinary retention. The other patient was referred for difficulty in micturition and abdominal pain which is the most common symptom of this entity.[ncbi.nlm.nih.gov]
Pneumonia
  • The epidermal disease was likely precipitated by Mycoplasma pneumoniae pneumonia. The patient presented with lower abdominal cramping and amenorrhea that had persisted for 5 months.[ncbi.nlm.nih.gov]
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. The intervention was performed by a vaginoscopic approach to preserve the integrity of the hymen.[ncbi.nlm.nih.gov]
Recurrent Abdominal 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]
  • Journal of Pediatric Orthopaedics, 10, 731-732. doi:10.1097/01241398-199011000-00005 McIvor, R.A. (1990) Haematocolpos once-in-a-lifetime cause of recurrent abdominal pain. Archives of Emergency Medicine, 7, 51-52.[file.scirp.org]
Abdominal Cramps
  • The patient presented with lower abdominal cramping and amenorrhea that had persisted for 5 months. Sonography demonstrated a markedly distended vagina filled with echogenic fluid.[ncbi.nlm.nih.gov]
Abdominal Tenderness
  • 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]
Low Back Pain
  • Hematocolpos should be included in the differential diagnosis of prepubertal girls who have low back pain.[ncbi.nlm.nih.gov]
  • Low back pain resulting from hematocolpos has been reported previously but not associated with symptoms of sciatica or neurologic weakness.[ncbi.nlm.nih.gov]
  • A large hematocolpos may cause persistent abdominal and low back pain due to pressure or by causing endometriosis, hydrosalpinx, hydroureter, or hydronephrosis.[consultant360.com]
Skeletal Dysplasia
  • "Diagnostic problems in a case with mucometrocolpos, polydactyly, congenital heart disease, and skeletal dysplasia" . American Journal of Medical Genetics . 66 (3): 343–346. doi : 10.1002/(SICI)1096-8628(19961218)66:33.0.CO;2-M . ISSN 0148-7299 .[en.wikipedia.org]
Sciatica
  • 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.[ncbi.nlm.nih.gov]
Imperforate Hymen
  • It is often caused by the combination of menstruation with an imperforate hymen . [1] [2] It is sometimes seen in Robinow syndrome , uterus didelphys , or other vaginal anomalies .[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]
  • Surgery is always indicated when imperforate hymen becomes symptomatic we report the case of an imperforate hymen who presented late with delayed menarche, massive hematocolpos and hematometra.[omicsonline.org]
  • Key words: Imperforate hymen, hematocolpos, acute abdominal pain. Journals Anales Médicos de la Asociación Médica del Centro Médico ABC Year 2012, Issue 4[new.medigraphic.com]
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]
  • 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]
  • 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]
  • The imperforate hymen is the simplest defect that results in primary amenorrhea. It may be associated with cyclic pelvic pain and a mass kidnapping perirectal with blood in vagina (hematocolpos).[new.medigraphic.com]
Primary Amenorrhea
  • The imperforate hymen is the simplest defect that results in primary amenorrhea. It may be associated with cyclic pelvic pain and a mass kidnapping perirectal with blood in vagina (hematocolpos).[new.medigraphic.com]
  • 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 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]
  • CONCLUSION: Physicians should be aware of transverse vaginal septum in the differential diagnosis of hematocolpos with abdominal pain and primary amenorrhea in the early adolescent years.[ncbi.nlm.nih.gov]
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]
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.[link.springer.com]
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

  • . [7] [8] [9] Treatment [ edit ] It is generally treated surgically, with a hymenotomy or other surgery to remove any tissue that blocks the menstrual flow.[en.wikipedia.org]
  • Early accurate diagnosis and treatment will decrease morbidity and unnecessary surgical procedures.[ncbi.nlm.nih.gov]
  • 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]
  • 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]
  • 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. [ 33 ] The retrograde menses[emedicine.medscape.com]

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]
  • Terapi : Terapi diberikan berdasarkan etiologi.[princeskalem.blogspot.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

  • 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]
  • Early recognition and treatment prevents severe complications of hematometra such as uterine rupture, infertility and endometriosis.[medcrave.com]
  • Posner JC, Spandorfer PR (2005) Early detection of imperforate hymen prevents morbidity from delays in diagnosis. Pediatrics 115(4):1008–1012, Print PubMed CrossRef Google Scholar 3.[link.springer.com]

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