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]
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]
We present the case of an 11-year-old girl who presented as a surgical emergency with acute abdominal pain. [sciencerepository.org]
Ideally, diagnosis should be made early during fetal and neonatal examinations to prevent symptomatic presentations of its complications at puberty. [omicsonline.org]
Immune System
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Splenomegaly
Results of abdominal ultrasonography were normal except for mild splenomegaly. [consultant360.com]
Entire Body System
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Collapse
(A) Sagittal pelvic ultrasonography image showing a huge cystic lesion (arrows) with internal hyperechoic materials compressing the collapsed urinary bladder (UB) anteriorly. The balloon (b) of the Foley catheter in the urinary bladder is also seen. [chikd.org]
Absence of hematocolpos demonstrated by collapsed vaginal cavity (white arrow) on ultrasound. Table 1. Literature review of hematacolpos/hematametra in setting of genital tract outlet obstruction. tum can affect the timing of presentation. [file.scirp.org]
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Vietnamese
Русский (Russian) ಕನ್ನಡ (Kannada) 한국어 (Korean) עברית (Hebrew) Український (Ukrainian) اردو (Urdu) Magyar (Hungarian) मानक हिन्दी (Hindi) Indonesia (Indonesian) Italiano (Italian) தமிழ் (Tamil) Türkçe (Turkish) తెలుగు (Telugu) ภาษาไทย (Thai) Tiếng Việt (Vietnamese [definitions.net]
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Turkish
Deutsch (German) العربية (Arabic) Français (French) Русский (Russian) ಕನ್ನಡ (Kannada) 한국어 (Korean) עברית (Hebrew) Український (Ukrainian) اردو (Urdu) Magyar (Hungarian) मानक हिन्दी (Hindi) Indonesia (Indonesian) Italiano (Italian) தமிழ் (Tamil) Türkçe (Turkish [definitions.net]
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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]
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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]
Gastrointestinal
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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]
There was no history of severe abdominal pain during the last year and the patient complained of polyuria during the last month; there were no signs of defecation. Her parents sought for medical assistance because of a growing tumor in her abdomen. [hindawi.com]
Musculoskeletal
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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 (inactive 2019-01-18). [thereaderwiki.com]
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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 10 3 /µL. [consultant360.com]
Neurologic
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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]
An unusual cause of sciatica in an adolescent girl. Spine 1996; 21: 1381-2. Little HK, Crawford DB, Meister K. Hematocolpos diagnosis made by ultrasound.JCU (J Clin Ultrasound) 1978; 6: 341-2. Van Bommel PJ, Abdullo O. [journalijar.com]
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Waddling Gait
Our patient complained of severe perineal and vaginal pain related to pressure from the mass, to the extent that she was having trouble sitting and had a waddling gait. [consultant360.com]
Urogenital
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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]
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]
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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]
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]
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Primary Amenorrhea
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]
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]
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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]
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Enlarged Uterus
Physical exam may reveal a palpable mass or enlarged uterus [1]. Additionally, diagnosis of any congenital malformation causing secondary hematometra is aided by pyelography and/or laparoscopy [1]. [medcraveonline.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]
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]
International Journal of Emergency Medicine volume 3, pages 481 – 482 ( 2010 ) Download Citation A previously healthy 12-year-old female was sent to the Emergency Department by her pediatrician for workup of severe suprapubic abdominal pain radiating [intjem.biomedcentral.com]
Ultrasound
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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]
She had an ultrasonography misdiagnosis of a huge ovarian mass before referral to our unit. On examination, the vagina was bulging and compressing the rectum. Repeat abdominal ultrasonography confirmed the diagnosis of hematometrocolpos. [journals.sagepub.com]
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]
Early accurate diagnosis and treatment will decrease morbidity and unnecessary surgical procedures. [ncbi.nlm.nih.gov]
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]
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]
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]
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]
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]