[Imperforate hymen: one diagnosis can hide another]
1Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France. enohuz@yahoo.fr
Summary
Imperforate hymen can cause acute abdominal pain in young girls, mimicking appendicitis. Early diagnosis and surgical hymenotomy are crucial for effective treatment and recovery.
Area of Science:
- Gynecology
- Pediatric Surgery
- Emergency Medicine
Background:
- Imperforate hymen is a rare congenital anomaly.
- Delayed diagnosis can lead to significant complications.
Observation:
- An 11-year-old girl presented with symptoms suggestive of appendicitis.
- Laparotomy revealed hemoperitoneum and a dilated fallopian tube, prompting further investigation.
- Pelvic examination and ultrasonography confirmed an imperforate hymen with significant fluid accumulation.
Findings:
- Surgical management involved hymenotomy, releasing 400cc of fluid.
- The patient recovered well after the procedure.
- This case highlights diagnostic challenges in pediatric acute abdomen.
Implications:
- Acute abdominopelvic pain in premenarchal girls warrants suspicion of imperforate hymen.
- Thorough gynecological examination is essential for timely diagnosis.
- Prompt surgical intervention (hymenotomy) is the definitive treatment.
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