Giant Hematocolpos and Hematometra in A Pubertal Girl: A Case Report and Review of Literature
Authors/Creators
- 1. Assistant Professor, All India Institute of Medical Sciences, Rishikesh, India
- 2. Postgraduate student, OBG, All India Institute of Medical Sciences, Rishikesh, India
- 3. Senior resident, OBG, All India Institute of Medical Sciences, Rishikesh, India
- 4. Professor, All India Institute of Medical Sciences, Rishikesh, India
Description
Abstract
Background
Imperforate hymen is an uncommon congenital malformation of vagina leads to accumulation of menstrual blood in vagina (hematocolpos) and uterus (hematometra).
Case
A 14-year-old girl presented with history of cyclic abdominal pain for six months and lower abdominal swelling for one month. She did not attain menarche till the time of presentation. On examination, her secondary sexual characteristics were normal for the age. Abdominal examination revealed a 24-26 weeks abdominopelvic mass, cystic in nature, tender on palpation. USG and MRI pelvis suggested gross hematocolpos and hematometra. Perineal examination was suggestive of imperforate hymen. Hymenotomy was performed under regional anaesthesia and approximately 1 liter of dark red colored old menstrual blood was drained.
Conclusion
Diagnosis and management of imperforate hymen is simple. But most of these cases diagnosed late or missed due to rarity of condition, vague symptoms, and inadequate gynecological examination. Awareness of such condition in young pubertal girl and a high index of suspicion is required for timely diagnosis and proper management.
Introduction
Accumulation of menstrual fluid in vagina and uterus is known as hematocolpos and hematometra respectively. In a pubertal girl, hematocolpos and hematometra may occur due to congenital malformation of the vagina such as vaginal septum, vaginal agenesis and imperforate hymen. Imperforate hymen is an uncommon congenital malformation of vagina. Reported incidence of imperforate hymen is approximately 0.05-0.1% [1]. Most of these girls present around puberty with complaint of primary amenorrhea, cyclical pain abdomen and sometimes with palpable mass per abdomen, urinary retention, constipation and bulging vaginal membrane at introitus [2]. Imperforate hymen occurs when hymen is failed to perforate during embryonic life to connect vestibule to vaginal canal leads to accumulation of menstrual blood in vagina (hematocolpos) and uterus (hematometra). If left untreated, it can further cause hematosalpinx and pelvic endometriosis.
We report a case of imperforate hymen with giant hematocolpos and hematometra in a pubertal girl.
Notes
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References
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