Hematometrocolpos Disguised as Abdominal Pain
Ramy Saleh1, George Katzenbach2, James Espinosa1
1Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, New Jersey.
The Journal of Emergency Medicine
|October 10, 2017
Summary
Hematometrocolpos due to an imperforate hymen is a rare pediatric anomaly. Prompt gynecologic history and examination are crucial for early diagnosis and management of this condition presenting as abdominal pain or urinary retention.
Area of Science:
- Pediatric Gynecology
- Emergency Medicine
- Radiology
Background:
- Hematometrocolpos, a rare pediatric anomaly caused by imperforate hymen, presents as vaginal outflow obstruction.
- Symptoms like abdominal pain, constipation, or urinary retention in amenorrheic females necessitate a thorough gynecologic history.
- Delayed diagnosis in emergency settings can lead to serious complications.
Observation:
- A 12-year-old female presented with abdominal pain and urinary symptoms.
- Computed tomography revealed findings consistent with hematometrocolpos.
- The patient's severe abdominal pain prompted the imaging.
Findings:
- Hematometrocolpos secondary to imperforate hymen was diagnosed.
- The condition can be easily missed due to vague, common symptoms like abdominal pain.
- Early detection through gynecologic history and examination is vital.
Implications:
- Emergency physicians must consider hematometrocolpos in young females with abdominal or urinary complaints.
- Timely diagnosis and surgical management can prevent long-term sequelae.
- This case highlights the importance of a gynecologic evaluation in pediatric abdominal pain evaluations.
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