Rectal sonography for diagnosing hematocolpometra. A case report

Imperforate hymen is an uncommon defect. Ultrasound may be useful in diagnosing hematocolpos, which is a common complication of imperforate hymen. The rectal approach with the ultrasound probe is an excellent method in aiding the diagnosis when the transvaginal approach is not feasible.

Imperforate hymen was suspected in an amenorrheic, 13-year-old girl who complained of cyclic lower abdominal pain. Her pubic hair and breast development were Tanner stage 3. Abdominal and pelvic examination confirmed a tender pelvic mass. A bluish, bulging hymen was noted. Abdominal ultrasound revealed a pelvic cystic mass. Rectal ultrasound confirmed the diagnosis of hematocolpometra.

Transrectal sonography provides an excellent alternative to transvaginal ultrasound in cases where transvaginal ultrasound is not feasible or is impossible. The rectal approach is appropriate due to the close proximity to the pelvic organs and patient acceptance of the procedure.