Hematometrocolpos in a Pubescent Girl with Abdominal Pain

Kotter, Haleigh; Weingrow, Daniel; Canders, Caleb P.

doi:10.5811/cpcem.2017.3.33369

Cited by 11 publications

(7 citation statements)

References 6 publications

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“…Cases are typically diagnosed after menarche due to symptoms manifesting as a result of the retrograde accumulation of blood in the vagina and uterus during menstruation [ 3 , 4 ]. The imperforate hymen may manifest with retained blood within the uterus (hematometria), vagina (hematocolpos), or both (hematometrocolpos) [ 5 ]. Diagnosis of hematometrocolpos can be made with ultrasonography revealing hypoechoic material within a distended uterus and vaginal canal.…”

Section: Discussionmentioning

confidence: 99%

“…This is especially helpful as the initial symptoms may be present in a wide range of pathologies, and the proper utilization of bedside ultrasonography may help to rapidly and accurately narrow the differential diagnosis. Treatment is based on identifying and treating the underlying imperforate hymen with surgical approaches and subsequent drainage of the hematometrocolpos [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

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Imperforate Hymen and Hematometrocolpos in a Female With Back Pain and Urinary Retention

Asikhia¹,

Durrani²,

Dugas³

et al. 2022

Cureus

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A 12-year-old female with primary amenorrhea presented to the emergency department with episodic low back pain, suprapubic discomfort, and acute urinary retention. A protruding purple mass was noted at the vaginal introitus consistent with an imperforate hymen. Point-of-care bedside transabdominal ultrasonography revealed a distended uterus containing hypoechoic material. The patient underwent formal pelvic ultrasonography, which revealed a markedly enlarged uterus containing a large number of blood products, thinned myometrium, and a distended vaginal canal consistent with hematometrocolpos secondary to imperforate hymen. Imperforate hymen is a rare congenital anomaly of the female urogenital tract, in which the hymen obstructs the vaginal opening causing a vaginal outlet obstruction. Vaginal outlet obstruction secondary to imperforate hymen may lead to retrograde menstruation with a collection of blood within the uterus and vagina, which is termed hematometrocolpos. Treatment is based on identifying and treating the underlying imperforate hymen with surgical approaches. The growing use of bedside ultrasonography allows the clinician to rapidly and accurately diagnose hematometrocolpos. The use of point-of-care bedside ultrasonography can serve as an essential tool as delayed diagnosis and treatment of this rare condition are associated with significant morbidity and lifelong infertility.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Imperforate Hymen and Hematometrocolpos in a Female With Back Pain and Urinary Retention

Asikhia¹,

Durrani²,

Dugas³

et al. 2022

Cureus

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“…In this instant case, even a cursory exam would have revealed that the problem was an imperforate hymen which would present as a bulging, protruding, bluish membrane that allows positive transillumination at the introitus. [14] This observation would also have resulted in a more appropriate referral and early treatment.…”

Section: Discussionmentioning

confidence: 99%

Adolescent Haematocolpos: Seek and You Shall Find

Pankevich¹

2021

CMR

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An adolescent girl presented to the emergency department with a history of abdominal pain, dribbling, and inability to pass urine for the last 24 hours. The initial observations and examination of respiratory, cardiovascular, ears, nose, and throat (ENT), central nervous system (CNS) and musculoskeletal systems were normal. No onset of menses reported by the patient. She was found to have a palpable distended bladder on abdominal examination. A catheter was inserted by the nurse, who reported no abnormalities. The physician did not perform a FAST scan nor conduct a genital examination. The patient was referred to the paediatrics department and the following day an ultrasound examination led to a diagnosis of haematometrocolpos. The patient was the referred to the obstetric and gynaecological department. Corrective surgery was conducted the following day and she was discharged on the fourth day. While the diagnosis and treatment were correct, had a FAST scan and/or genital examination been part of the initial work-up, diagnosis would have been made in the emergency department and an appropriate referral made directly to obstetric and gynaecological team. Rapid diagnosis and treatment would have benefitted the patient, reduced the risks of complications, and cut the length of stay in the hospital by as much as two days.

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“…Given that normal menses typically include 30 to 80 mL of blood and frequently 900 mL of blood or more are evacuated at the time of surgery menarche could have been on-going for many months before presentation. [16][17][18] The average age of menarche in the United States is age 12 in white girls and 11 in black and Hispanic girls, but can be as early as 9 to 10 years of age. In a systematic review of imperforate hymen, the majority of patients (65%) presented between age 12 and 18, compared with 14% between ages 2 and 12.…”

Section: Prepubertalmentioning

confidence: 99%

“…They typically present within 3 to 6 months from the onset of menstruation. Given that normal menses typically include 30 to 80 mL of blood and frequently 900 mL of blood or more are evacuated at the time of surgery menarche could have been on-going for many months before presentation 16–18…”

Section: Introductionmentioning

confidence: 99%

Imperforate Hymen: Clinical Pearls and Implications of Management

Hamouie

Dietrich

2022

Clinical Obstetrics &Amp; Gynecology

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Imperforate hymen is a common condition that with classic appearance and presentation in puberty. This may be diagnosed in a neonate when mucocolpos is noted. There are many great pretenders of this condition, but the hallmarks include a bulging hymen with blue hue at puberty. If this is not seen on external genital exam, the provider should proceed with magnetic resonance imaging to better assess the reproductive tract anatomy before engaging in surgery. For providers uncomfortable in managing conditions often confused with an imperforate hymen, referral to a Pediatric and Adolescent Gynecologist or specialist comfortable managing these conditions, is recommended.

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Hematometrocolpos in a Pubescent Girl with Abdominal Pain

Cited by 11 publications

References 6 publications

Imperforate Hymen and Hematometrocolpos in a Female With Back Pain and Urinary Retention

Imperforate Hymen and Hematometrocolpos in a Female With Back Pain and Urinary Retention

Adolescent Haematocolpos: Seek and You Shall Find

Imperforate Hymen: Clinical Pearls and Implications of Management

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