Abstract
Background
Imperforate hymen typically presents in adolescence with pain, hematocolpometra and
primary amenorrhea. This case documents a previously unreported etiology for an atypical
presentation with a history of recent menstruation.
Case
A female adolescent presented with symptoms of urinary retention and leg pain. She
reported a history of irregular, painful menses. Clinical examination revealed a pelvic
mass and imperforate hymen. Sonography was consistent with hematocolpometra. Before
a planned hymenectomy, the patient began to pass dark blood through a fistulous opening
in her vulva. Hymenectomy resulted in complete resolution of the pain and hematocolpometra.
Summary and Conclusion
Identification of the fistulous tract explained the patient's history of menstrual
bleeding despite an imperforate hymen. Spontaneous rupture of hematocolpometra through
a fistulous tract to the vulva is a previously unreported atypical presentation of
imperforate hymen in a “menstruating” adolescent with pain and a pelvic mass.
Key Words
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Article info
Publication history
Published online: July 24, 2015
Footnotes
The author indicates no conflicts of interest.
Identification
Copyright
© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
