Typical appearance of a hematocolpos.  In a young adolescent patient this is most likely due to an imperforate hymen, however a vaginal septum should be looked for as a differential, either as an isolated abnormality or in association with Mullerian duct anomalies.  There was no evidence of a vaginal septum in this case.

The mass effect caused by the hematocolpos was likely the cause of the patient's constipation - which was the sole presenting complaint.