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[Hematocolpos from an imperforate hymen in children. Clinical and ultrasonic aspects]

C Bolesani1, P A Formentin, V Pizzo

  • 1Divisione di Pediatria, Presidio Ospedaliero di Cittadella, Padova, Italia.

Insights

Hematocolpos, a condition of blood accumulation, can result from an imperforate hymen in adolescent girls. Ultrasound imaging is crucial for diagnosing this rare genital malformation presenting with primary amenorrhea and abdominal pain.

Area of Science:

  • Pediatric Surgery
  • Medical Imaging
  • Gynecology

Background:

  • Hematocolpos is a rare condition characterized by the accumulation of menstrual blood in the vagina.
  • Imperforate hymen is a congenital anomaly where the hymenal opening is completely closed, obstructing menstrual outflow.
  • Primary amenorrhea, the absence of menstruation by age 15, can be a presenting symptom.

Observation:

  • A case study involving a 13-year-old girl with hematocolpos secondary to an imperforate hymen was investigated.
  • Ultrasound imaging was utilized as the primary diagnostic tool to visualize the internal pelvic structures.
  • The diagnostic images provided clear evidence of the hematocolpos and the underlying imperforate hymen.

Findings:

  • Ultrasound successfully identified significant blood accumulation within the vagina (hematocolpos).
  • The underlying cause, an imperforate hymen, was clearly visualized, confirming the obstruction.
  • The patient presented with primary amenorrhea and significant abdominal colics.

Implications:

  • This case highlights the importance of considering genital malformations in adolescent girls presenting with primary amenorrhea and abdominal pain.
  • Early diagnosis through imaging modalities like ultrasound is critical for timely surgical intervention.
  • Prompt recognition and management can prevent complications and improve patient outcomes in cases of imperforate hymen.

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