AI Article Synopsis
- A case of an 11-year-old girl with an imperforate hymen was discovered after she presented with symptoms initially suggesting appendicitis.
- A surgical procedure revealed complications including hematocolpos and a dilated fallopian tube, leading to a diagnosis of the hymen issue.
- The case emphasizes the importance of considering an imperforate hymen in pubertal girls with acute abdominal pain and outlines that surgical hymenotomy is the effective treatment.
Article Abstract
Introduction: A case of imperforate hymen discovered after a surgical complication is reported. We discuss the lessons to draw from this case in terms of diagnosis and therapeutic management.
Case Report: An 11-year-old girl was referred with fever and acute lower abdominal pain. A diagnosis of appendicitis was hypothesized because of rigidity located to the right iliac fossa, a psoas sign, polynuclear leukocytosis, and increased serum C-reactive protein. A McBurney laparotomy showed a brownish hemoperitoneum and a dilated right fallopian tube. The appendix appeared normal and an appendicectomy was done. A diagnosis of hematocolpos aggravated by hematometra, hematosalpinx, and hemoperitoneum was suspected. Pelvic examination revealed an imperforate hymen with a taut pelvic mass confirmed by transabdominal and endorectal ultrasonography. Hymenotomy was performed, which allowed the discharge of 400cc of chocolate-colored fluid. The history-taking revealed recurrent intermittent lower abdominal pain with several referrals to emergency departments. The patient recovered uneventfully and was discharged 2 days later.
Conclusion: In case of acute abdominopelvic pain in pubertal girls with no previous menstruation, the possibility of an imperforate hymen must be suspected. Examination should include observation of secondary sexual characteristics and inspection of the external genitalia. Treatment is surgical and consists of a hymenotomy.
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| http://dx.doi.org/10.1016/j.arcped.2010.01.022 | DOI Listing |
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Article Synopsis
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- In a reported case of an 11-year-old girl, severe abdominal pain due to huge hematocolpos was addressed through physical examination, emphasizing the importance of early detection.
- The treatment involved a surgical procedure that included hymenectomy, blood drainage, and hymenoplasty, allowing the patient to regain normal urinary and bowel functions soon after surgery and resume menstruation three weeks later.
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