A Full Uterus: Hematometra from Cervical Scarring

A 29-year-old female presented with abdominal pain, nausea, and vomiting. She reported no menstrual period for one year. She did report monthly episodes of severe cramping. A loop electrosurgical excision procedure was performed approximately 10 months prior. On pelvic exam, a smooth cervix with scarring over the os was visualized with no evidence of cervical opening. A pelvic ultrasound showed an enlarged uterus with contents within the endometrial cavity likely representing hemorrhage of different ages and ongoing bleeding. Gynecology was consulted and performed an incisional opening of the cervix. The patient was diagnosed with hematometra from scarred cervical os.