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.
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
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
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
adv hb ,bt/ct...keep blood arranged ...fr transfusion ...sm time bt requride
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14 yrs old girl Slight Anaemic Pain in abd since 2_3 mths No menses till date. Today's USG findings r posted below Please give y'r valuable opinions. Thanks & regards.Dr. Vasundhara Nanavaty7 Likes18 Answers
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ABC OF : ENDOMETRIOSIS. MAY BE USEFUL. ***** ENDOMETRIOSIS :- MORE THAN 1 MILLION CASES PER YEAR (INDIA)....... TREATABLE BY A MEDICAL PROFESSIONALS....... REQUIRES A MEDICAL DIAGNOSIS....... LAB TESTS OR IMAGING OFTEN REQUIRED....... CHRONIC: CAN LAST FOR YEARS OR BE LIFELONG....... ** CONSULT A DOCTOR FOR MEDICAL ADVICE....... *** ENDOMETRIOSIS is an estrogen-dependent disease wherein endometrial-like tissue is found outside the uterus inducing a chronic inflammatory response....... Pelvic organs (esp ovaries) & peritoneum are frequently affected....... *** SYMPTOMS :- MAIN CLINICAL FEATURES INCLUDE: CHRONIC PELVIC PAIN (found in 70-80% of patients) DYSPAREUNIA (suggests deep posterior infiltration) INFERTILITY (21% prevalence rate) OTHER SYMPTOMS may include severe dysmenorrhea, pain on ovulation, noncyclical pelvic pain, cyclical bowel or bladder symptoms w/ or w/o abnormal bleeding or pain, chronic fatigue, or dyschezia....... 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pt namrataben 14 yrs.referred from pvt.for transverse vaginal septum trial under g/A done vaginally but unsuccessful. Pt had complained of pain in lower abdomen periodically since last six month and on USG shows collection in genital tract with hematosalpinx.we have done MRI shows more collection in upper vagina,10*10 cm and haematosalpinx with transverse vaginal septum at upper 2/3rd and lower 1/3rd junction but thickness not exactly elicited.uterus bulky with small haematometra.stretched fornix due to haematocolpus.by considering hymen intactness,age of pt,and previous failed vaginal trial I examine pt under anaesthesia P/R done big cystic mass felt may in vagina.small incision kept 2 finger above pubic symphysis 4 cm transverse.per op.it bulky sit over big vaginal collection ,rt.side hematosalpinx with fimbrial block and adhesion present,left side 5*5 cm cyst with thick edematous tube and in mesosalpnx 3*3 cm thick dark blood collection present also adhesion present.I had put incision 1*1 cm on top ant.stretched fornix and suction done all haematocolpus about 700cc.than anatomy somewate clear and rt. And Lt adhesiolysis done and rt side open fimbrial end and suction done on Lt.aspirate cyst ,capsule of cyst removed and with 2-0 vicry 3 stitches taken.and also below salpinx collection removed.both side check for hemostasis.then I had insert middle finger from incision of ant.fornix to vagina press the septum and catch it from below gently dissected it meticullously whole tract open roller pack kept from above and 8 no.Folly's in vagina 15 cc inflation done.then closed ant.fornix incision done. Interseed kept over closed incision.thorough peritoneal lavage given.U/o adequate.pt.well.vaginal catheter for 15 days and adviced to remove vaginal pack after 24 hrs.no bld p/v.in future after marriage vaginoscopy and hyseroscopy adviced.hymen intact post.op.USG after 1 month adviced.skin subcuticular stitch taken.your advice needed guide me further friends.Dr. Trupti Nayak5 Likes10 Answers
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29 yr female sudden belly pain oophrectomy done . Ovary 5/4/3.5 cm. One watery cyst 3 cm, second haemorrhagic cyst , last two sections of watery cystDr. Yashpal Jalpota0 Like16 Answers