Emergency Point-of-Care Ultrasound Diagnosis of Hematocolpometra and Imperforate Hymen in the Pediatric Emergency Department

Fischer, Jason; Kwan, Charisse

doi:10.1097/pec.0000000000000080

Cited by 14 publications

(8 citation statements)

References 19 publications

(4 reference statements)

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“…Transabdominal emergency point-of-care ultrasound can be useful in facilitating a diagnosis in the emergency department [9,10]. Another series of 13 cases of imperforate hymen, found that those diagnosed in the emergency department were significantly more likely to be admitted under gynaecology, receive a timely corrective procedure and be discharged sooner [10].…”

Section: Discussionmentioning

confidence: 99%

Hematocolpos secondary to imperforate hymen presenting with acute abdominal pain and misdiagnosed as appendicitis: a case report and literature review

Sengupta¹,

Lovell²,

Mittal³

2018

The Great Imposture: Eosinophilic Cholangitis

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Imperforate hymen is a rare congenital malformation that usually presents in adolescence with primary amenorrhoea and pain or pressure-related symptoms from haematocolpos. We present the case of an 11year-old girl who presented as a surgical emergency with acute abdominal pain. A laparoscopy was performed for suspected appendicitis, but she was subsequently found to have a haematocolpos secondary to imperforate hymen. This case illustrates the challenges in making the diagnosis. The literature contains numerous cases where the diagnosis has been delayed, and we discuss those that also presented as possible appendicitis. These cases highlight the importance of awareness of the condition amongst general surgeons and emergency physicians, and the role of external genital examination and ultrasonography prior to surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Hematocolpos secondary to imperforate hymen presenting with acute abdominal pain and misdiagnosed as appendicitis: a case report and literature review

Sengupta¹,

Lovell²,

Mittal³

2018

The Great Imposture: Eosinophilic Cholangitis

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“…In imperforate hymen, the vaginal orifice is occluded by a hymen without an opening. The prevalence of imperforate hymen is estimated at one in 1000 to one in 2000 females [5,21]. Although rare cases of familial imperforate hymen have been reported [11,22], most cases are thought to occur sporadically.…”

Section: Imperforate Hymenmentioning

confidence: 99%

“…3b, c). MRI is a valuable imaging tool for assessing the extent of hematocolpos, hematometra and/ or hematosalpinx, the thickness of the imperforate hymen, and related complications such as infection, hydronephrosis and endometriosis [5,29]. The schematic illustration of the imperforate hymen is shown in Fig.…”

Section: Imperforate Hymenmentioning

confidence: 99%

“…Hydrocolpos due to congenital urogenital anomalies could be discovered during the prenatal and postnatal periods owing to the collection of secretions in the obstructed vagina under the influence of maternal hormones [2,3]. However, most patients are detected at puberty with several symptoms due to hematocolpos or hematometrocolpos [4][5][6][7]. Clinical symptoms are often nonspecific and include suprapelvic tender mass, cyclical lower abdominal pain, constipation, vomiting, and urinary retention [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Congenital anomalies causing hemato/hydrocolpos: imaging findings, treatments, and outcomes

Tanitame

Urayama

et al. 2021

Jpn J Radiol

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Hemato/hydrocolpos due to congenital urogenital anomalies are rare conditions discovered in neonatal, infant, and adolescent girls. Diagnosis is often missed or delayed owing to its rare incidence and nonspecific symptoms. If early correct diagnosis and treatment cannot be performed, late complications such as tubal adhesion, pelvic endometriosis, and infertility may develop. Congenital urogenital anomalies causing hemato/hydrocolpos are mainly of four types: imperforate hymen, distal vaginal agenesis, transverse vaginal septum, and obstructed hemivagina and ipsilateral renal anomaly, and clinicians should have adequate knowledge about these anomalies. This article aimed to review the diagnosis and treatment of these urogenital anomalies by describing embryology, clinical presentation, imaging findings, surgical management, and postoperative outcomes.

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“…Clinical presentation can occur in infancy with inter‐labial swelling or, more commonly, in adolescent girls presenting with primary amenorrhoea, a bulging hymenal membrane, cyclical abdominal pain and/or a pelvic mass. A review of the literature demonstrates that there are numerous case reports of ‘rare’ presentations, with other presenting symptoms including urinary retention, acute kidney injury, constipation and tenesmus, back pain and dyspareunia …”

mentioning

confidence: 99%

Imperforate hymen: Retrospective review from a single tertiary centre of presenting symptoms and diagnostic process

Lazanyi

Grover

2019

J Paediatrics Child Health

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Aim: To review presentations, diagnostic processes and time to diagnosis of presentations of imperforate hymen at one tertiary paediatric hospital over a 10-year period. The aim was to improve knowledge, enable targeted education and reduce unnecessary tests and diagnostic delay for this congenital obstructive disorder of the female reproductive tract. Methods: A pragmatic, retrospective, observational study was conducted of all female patients, aged younger than or equal to 18 years of age, presenting to the Royal Children's Hospital, Melbourne, over an 18-year period. Presenting symptom(s), time to diagnosis, investigations ordered and number of health-care professionals consulted prior to diagnosis were recorded. Results: A total of 27 patients met eligibility criteria, and 85% presented with pain (23/27). Pain was frequently associated with other symptoms (15/23). Over three quarters of patients consulted more than one health-care professional prior to diagnosis (22/27). Of the 27 patients, 19 had imaging undertaken prior to diagnosis. Conclusions: Paediatric and adolescent females managed at our tertiary paediatric hospital are experiencing diagnostic uncertainty and the unnecessary ordering of imaging prior to a diagnosis of imperforate hymen. Targeted education is recommended to health professionals managing female paediatric and adolescent patients.

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Emergency Point-of-Care Ultrasound Diagnosis of Hematocolpometra and Imperforate Hymen in the Pediatric Emergency Department

Cited by 14 publications

References 19 publications

Hematocolpos secondary to imperforate hymen presenting with acute abdominal pain and misdiagnosed as appendicitis: a case report and literature review

Hematocolpos secondary to imperforate hymen presenting with acute abdominal pain and misdiagnosed as appendicitis: a case report and literature review

Congenital anomalies causing hemato/hydrocolpos: imaging findings, treatments, and outcomes

Imperforate hymen: Retrospective review from a single tertiary centre of presenting symptoms and diagnostic process

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