EP24.36: Hematocolpos due to imperforate hymen: a case report and literature systematic review

Hematocolpos is a rare medical condition that can occur in a young girl and is characterised by the accumulation of menstrual blood in the vagina and eventually the uterus due to an obstruction in the vaginal canal, cervix or the opening of the vagina. We report a rare case of an hematocolpos in a 12-year-old. The patient was a 12 year old girl with no surgical or medical history. She has not yet menstruated. Her mother consulted the emergency department for acute abdominal pain and bloating. During the interrogation, she reported cyclic pelvic pain starting eight months ago. General examination revealed a well-maintained general state. The secondary sexual characteristics were present (Tanner's stage V). The abdomen exam showed a distended abdomen with a hypo-gastric mass firm mobile and renitent reaching as far as the umbilicus. On pelvic examination, we found a bulging and imperforated hymen. Suprapubic ultrasound revealed an upwardly displaced uterus, distended by the presence of hematometra, defined as the presence of a retrovesical, median, hypoechoic fluid formation of 15 *9cm inside the uterine cavity. We also found a bilateral hematosalpinx. Thus, the diagnosis was hematocolpos on an imperforate hymen. The goal of the management is to timely perform hymenotomy after locating the urinary meat to drain the hematocolpos, followed by hymenectomy to prevent recurrence. The hymenotomy produced 800mL of blood in our patient. Follow-up is needed to diagnose possible recurrences. The result was satisfying. In the case of an adolescent girl complaining of genital pain associated with primary amenorrhea, hematocolpos due to imperforate hymen should be suspected. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.