A Case Report of Hematometrocolpos in Two Adolescents: Divergent Clinical Presentations and Diagnostic Challenges

Hematometrocolpos is an infrequent congenital anomaly (Mullerian duct anomaly) that results in an imperforate hymen, followed by accumulation of menstrual blood in the vagina and or uterus in prepubertal girls results in retrograde menstruation. This commonly manifests as abdominal pain in premenarcheal pubescent girls. We discuss the case of two adolescent girls who presented to the emergency with lower abdominal pain, constipation, back pain, and/or urinary retention. They were found to have an imperforate hymen and hematometrocolpos. The diagnosis was made with the use of a genital examination and ultrasound. Hymenotomy was performed successfully in both cases and the patients recovered completely without complications. Failure to diagnose premenstrual girls presenting with lower abdominal pain and/or retention of urine with hematometrocolpos might lead to complications like infertility, endometriosis, tubal infections, adhesions, etc.