Hymeneal Iperforation with Significant Hydrocolpos at Birth: A Case Report

<i>Background:</i> Imperforate hymen is a rare congenital anomaly of the female genital tract. It is often diagnosed in adolescence due to symptoms related to hematocolpos. However, it can present in the neonatal period with significant hydrocolpos, which can lead to abdominal distension and other complications. <i>Case Presentation:</i> We report a case of a newborn female presenting with significant hydrocolpos due to an imperforate hymen. The infant was born at term through vaginal delivery with no complications during pregnancy. On physical examination shortly after birth, the infant exhibited marked abdominal distension. Ultrasound examination revealed a large cystic mass in the pelvic region consistent with hydrocolpos. <i>Diagnosis and Management:</i> The diagnosis of imperforate hymen was confirmed through a thorough physical examination. A small bulging membrane was observed at the introitus, and subsequent imaging supported the diagnosis. A hymenotomy was performed under general anesthesia, and approximately 50mL of milky fluid was drained from the vaginal canal. The infant's recovery was uneventful, and follow-up examinations showed no recurrence of symptoms. <i>Discussion:</i> This case underscores the importance of considering imperforate hymen in the differential diagnosis of a newborn with abdominal distension. Early recognition and prompt surgical intervention are crucial to prevent complications such as urinary obstruction, infection, and potential damage to the reproductive organs. Neonatal hydrocolpos due to imperforate hymen is rare but should be recognized as a possible etiology in similar presentations. <i>Conclusion:</i> Imperforate hymen with significant hydrocolpos can present in the neonatal period. Early diagnosis and surgical management are essential for a favorable outcome. This case highlights the need for awareness among clinicians regarding this rare but treatable condition.