a 16 year old girl came for abdominal pain, in history she has no menses till the time. lower abdomen distended, usg shows... uterine and vaginal cavity is grossly distended and filled with echogenic material measures 6#3.5 in the uterine cavity and 12.8#7.5cms in the vaginal cavity s/o hematometrocolpos. both ovaries are bulky with multiple df in the right ovary and 30 mm hemorrhagic cyst in the left ovary. dear colleagues differential diagnosis and treatment advice.

2 Likes

LikeAnswersShare

CT and MRI will confirm the diagnosis.causes may be imperforate then, complete vaginal stenosis, segmental vaginal atresia, transverse vaginal septum. association with imperforate amid, uterus didelphys, reanal agenesis should be kept in mind. for hematometrocolpos m/m is cruciate incision of hymen under GA.

imperforate hymen
1

View 4 other replies

by symptomes and usg and clinically it's imperforated hymen go for crusiate hymen on hymen and head up position for drainage of material and DON'T APPLY PRESSURE OVER ABDOMEN AND UTERUS AS IT INCRESE RISK OF ENDOMETRIOSIS IN FUTURE.

- Imperforated Hymen - Needs Surgical intervention - Put a Cruciate incision & drain collected menstrual blood - treat ovarian pathology later

IN IMPERFORATE HYMEN THE MOST COMMON EMERGENCY PRESENTATION IS ACUTE RETENTION URINE WITH PAIN ABDOMEN.THE CYCLICAL PAIN IS NOT OF MUCH COMMON.IF RETENTION URINE IS ITS AN EMERGENCY TO RELIVE THE PRESSURE ON BLADDER .BEFORE DOING THE PROCDURE COUNCELLING OF PARENTS DISCUSSION ABOUT FUTURE MARITAL STATUS.IF THE PLANING OF MARRIAGE FAR AWAY GIVE CRUCITE LIKE INSCION WITH TRIMMING OF CORNERS AT 2,4,8,110CLOCK POSITION.IF SHE IS MARRIED OR PLANING SINGLE OBLIQUE INSCION IS ENOUGH.

what's your clinical findings.don't blindly follow usg or mri.corellate clinically also.when u waste time in such pt might blood pushed in peritoneal cavity from tubes.

thanks to everyone, her mri pelvis report conclusion is... uterus appears grossly bulky in size. large altered signal intensity collection appearing hyperintense on t2/t1seen in the endometrial cavity, represents subacute haematometra? stenosis, moderate hemato salphinx seen on both sides.

Could be imperforated hymen, transverse vaginal septum,vaginal atresia and for imperforated hymen treatment is cruciate incision

could be imperforated hymen,transverse vaginal septum, vaginal atresia and for imperforated hymen treatment of choice is cruciate incision
1

16yr young girl with pain diagnosis is obvious as per usg hematocolpos and hematometra.howevere do local exam -if balloning of hymen -think of imperforate hymen .do pr to see extent of vaginal fullness .as transverse septum can be second possibility. r/o associated renal anamolies. Inthis case I will not sugfest

ct /MRI unless dignosis is not clear. needshymwnectomy with cruciate incision.hemorhagic cyst needs follow up if not large or painful .
0

The professional diagnosis for this case is imperfermate hymen. She needs surgical intervention, i.e., under spinal anaesthesia. The ultrasound digestive of left haemorrhagic cyst. She needs to follow up ultrasound after the months. Usually the haemorrhagic cyst resolves in time. Max 3-6 months

professional..I mean provisional diagnosis. not digestive..it is suggestive.
0

adv hb ,bt/ct...keep blood arranged ...fr transfusion ...sm time bt requride

Load more answers

Diseases Related to Discussion

Transverse Vaginal Septum
Vaginal Atresia
Endometriosis

Cases that would interest you