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Unique Case of Imperforate Hymen
1Baptist Medical Centre, Nalerigu, Ghana.
Journal of Pediatric and Adolescent Gynecology
|July 29, 2015
Summary
An imperforate hymen (a blocked hymen) can present atypically. This case shows a rare instance where a fistulous tract allowed menstrual blood to exit, causing pain and a pelvic mass in an adolescent.
Area of Science:
- Gynecology
- Pediatric Surgery
- Reproductive Health
Background:
- Imperforate hymen typically causes primary amenorrhea and pelvic pain in adolescents.
- This case presents an unusual etiology for an imperforate hymen with a history of menstruation.
Observation:
- A female adolescent experienced urinary retention and leg pain.
- Clinical examination revealed a pelvic mass and imperforate hymen with hematocolpometra.
- The patient passed dark blood through a vulvar fistulous opening before hymenectomy.
Findings:
- A fistulous tract explained menstrual bleeding despite an imperforate hymen.
- Spontaneous rupture of hematocolpometra via a fistulous tract is a novel presentation.
- Hymenectomy resolved pain and hematocolpometra.
Implications:
- This case expands the understanding of imperforate hymen presentations.
- Highlights the importance of considering fistulous tracts in atypical gynecological cases.
- Informs clinical diagnosis and management of adolescent pelvic masses and menstrual irregularities.
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