Hematocolpos due to lower vaginal agenesis in an adolescent girl

Background Hematocolpos due to imperforate hymen is an important differential diagnosis of abdominal pain in early adolescent stage. However, hematocolpos due to lower vaginal agenesis must be considered because the management differs. Case Presentation A healthy 11‐year‐old girl presented with a 2‐...

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Published in:Acute medicine & surgery 2023-01, Vol.10 (1), p.e832-n/a
Main Authors: Imai, Kazunori, Aoyama, Kohei, Goto, Takato, Kitaori, Tamao, Iguchi, Toshiyuki, Sasano, Hiroshi, Hattori, Tomonori, Sugiura‐Ogasawara, Mayumi, Saitoh, Shinji
Format: Article
Language:English
Subjects:
Abdomen
Abdominal pain
Blood
Case Report
Cervix
Children & youth
Collaboration
Disease
Emergency medical care
Females
Fertility
Girls
hematocolpos
Informed consent
Magnetic resonance imaging
Menarche
mullarian aplasia
Pain
Puberty
Rectum
Retention
Tomography
Ultrasonic imaging
Uterus
Vagina
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Summary:Background Hematocolpos due to imperforate hymen is an important differential diagnosis of abdominal pain in early adolescent stage. However, hematocolpos due to lower vaginal agenesis must be considered because the management differs. Case Presentation A healthy 11‐year‐old girl presented with a 2‐day left lower abdominal pain history. Her breast development had begun, but she had not reached menarche. Computed tomography showed high absorptive value liquid filling the upper vaginal to uterine cavity, a pale highly absorptive fluid component suggestive of hemorrhagic ascites in the abdominal cavity on both sides of the uterus, and normal bilateral ovaries. Magnetic resonance imaging diagnosed hematocolpos due to lower vaginal agenesis. The blood clot was aspirated with a transabdominal ultrasound‐guided transvaginal puncture. Conclusion History‐taking, imaging tests, and appropriate collaboration with obstetrician/gynecologist with awareness of secondary sexual characteristics were crucial in this case. Hematocolpos due to vaginal agenesis with a functional uterus are particularly rare and are sometimes misdiagnosed in adolescent females because of the diversity in symptoms. Major complaints in cases diagnosed during adolescence are often lower abdominal pain, back pain, cancelation dysfunction, and primary amenorrhea. History‐taking, imaging tests, and appropriate collaboration with obstetrician/gynecologist with awareness of secondary sexual characteristics were crucial in this case.
ISSN:2052-8817
2052-8817
DOI:10.1002/ams2.832