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Hematometrocolpos

Case contributed by Kewal Arunkumar Mistry
Diagnosis almost certain

Presentation

Lower abdominal pain with palpable pelvic mass. No history of prior menstruation.

Patient Data

Age: 13 years
Gender: Female
ultrasound

Vaginal canal is grossly distended with fluid showing low level internal echoes. Uterus is normal in size however it is pushed anterosuperiorly and shows fluid in endometrial cavity. Findings are consistent with gross hematocolpos with hematometra.

On examination imperforate hymen was found.

ultrasound

Postoperative ultrasound shows collapsed vaginal canal with marked wall thickening and presence of air foci within it.

Case Discussion

On examination tense bluish membrane was present at introitus suggestive of imperforate hymen. Hymen was incised and approximately 500 ml of sanguineous fluid was removed.  

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