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Hematocolpos

Case contributed by Cristina-Mihaela Popescu
Diagnosis almost certain

Presentation

Amenorrhea, spotting after micturition.

Patient Data

Age: 14 years
Gender: Female
ultrasound

On sagittal view of the pelvis, the uterus (34X29 mm) (fig 1), and cervix are visualized. The vagina is distended by a fluid collection with internal echoes (best seen on fig 5). It measures 111X86 mm (sagittal plane) (fig 6) and has a mass effect on the bladder (fig 7).

Case Discussion

Hematocolpos is the accumulation of blood inside the vagina. It is caused by an imperforate hymen (or microperforate hymen), vaginal agenesis, or vaginal atresia. Most patients suffer from pelvic and/or back pain, constipation, and acute urinary retention.

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