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Two cases of pyometrocolpos due to distal vaginal atresia
Mustafa Imamoğlu1, Ali Cay, Haluk Sarihan
1Department of Pediatric Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey. mimamoglu61@yahoo.com
Insights
Urgent percutaneous drainage of pyometrocolpos in children with vaginal atresia significantly improves acute illness. This minimally invasive approach allows infection to resolve, facilitating subsequent definitive surgical repair.
Area of Science:
- Pediatric Surgery
- Medical Imaging
- Gynecology
Background:
- Pyometrocolpos, a rare condition in children resulting from distal vaginal atresia, can lead to severe obstructive uropathy and septicemia.
- Prompt management is crucial for improving the clinical course in affected children.
Observation:
- Two pediatric patients presented with acute illness secondary to pyometrocolpos and distal vaginal atresia.
- High-risk factors, including complex drainage needs and general anesthesia risks, were identified.
Findings:
- Computed tomography-guided percutaneous drainage with catheter placement was successfully performed via the lower abdominal wall.
- This minimally invasive procedure led to a dramatic improvement in clinical status and resolution of local inflammation within 4-6 weeks.
Implications:
- Percutaneous drainage offers a safe and effective temporary measure for managing pyometrocolpos in high-risk pediatric patients.
- This approach facilitates definitive surgical correction by stabilizing the patient and resolving infection.
Abstract:
Children with pyometrocolpos due to distal vaginal atresia may present as acutely ill, with severe obstructive uropathy and septicemia. In such patients the clinical course is markedly improved by urgent drainage of the infected cystic mass, and a temporary drainage procedure is required to allow local findings of infection to subside before definitive surgery. We present two children with pyometrocolpos with the above-mentioned clinical course, in whom percutaneous drainage with computed tomography-guided catheter placement through the lower abdominal wall was performed because of the high risks of complex drainage procedures and general anesthesia. This drainage did result in dramatically improved clinical status, and findings of local inflammation resolved within 4-6 weeks, which facilitated a later successful definitive surgical procedure.