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Hematometra presenting as an acute abdomen in a 13-year-old postmenarchal girl: a case report
Peter Klimek1, Miriam Klimek, Ulf Kessler
1Department of Pediatric Surgery, Inselspital, University of Berne, Berne, Switzerland. Ulf.Kessler@insel.ch.
Introduction:
Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where the anomaly could not be identified using a laparoscopy in an adolescent girl with acute abdomen.
Case Presentation:
A 13-year old postmenarchal caucasian female presented with an acute abdomen. Emergency sonography could not exclude ovarian torsion. Accurate diagnosis and treatment were achieved only after an initial laparoscopy followed by a laparotomy and after a magnetic resonance imaging scan a further laparotomy. The underlying disease was hematometra of the right uterine horn in a uterus didelphys in conjunction with an imperforate right cervix.
Conclusion:
This report demonstrates that the usual approach for patients with acute abdominal pain may not be sufficient in emergency situations.
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