Symptomatic Imperforate Hymen in Early Infancy: A Case Report

Area of Science:

• Pediatric Surgery
• Gynecology
• Urology

Background:

• Imperforate hymen is a congenital anomaly typically diagnosed in late puberty.
• Symptoms include abdominal pain, primary amenorrhea, and cyclical pain due to hematocolpos and hematometra.
• Infantile presentation of symptomatic imperforate hymen is exceptionally rare.

Observation:

• A female infant presented with acute urinary retention, fever, chills, and rigor.
• Physical examination revealed an abdominopelvic mass and absence of a vaginal opening.
• Contrast-enhanced computed tomography confirmed a large abdominopelvic cystic lesion consistent with a distended vagina.

Findings:

• The infant's symptoms were attributed to a distended vagina secondary to an imperforate hymen.
• Surgical management involved incision of the imperforate hymen and drainage of accumulated pus.
• Successful treatment resolved the urinary retention and abdominal mass.

Implications:

• A high index of suspicion is essential for diagnosing imperforate hymen in infants presenting with urinary retention or abdominal masses.
• Prompt surgical intervention can effectively manage symptomatic imperforate hymen in infancy.
• This case underscores the importance of considering rare congenital anomalies in the differential diagnosis of infantile abdominal masses and urinary symptoms.