Case Report| Volume 29, ISSUE 1, e1-e3, February 2016

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Unique Case of Imperforate Hymen

  • Lynn Coppola
    Address correspondence to: Lynn Coppola, MD, MPH, Department of Obstetrics and Gynecology, University of Arizona Medical Center, PO Box 245078, 1501 North Campbell Ave, Tucson, AZ 85742; Phone: +1 (520) 626-5998
    Baptist Medical Centre, Nalerigu, Ghana
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      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.


      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.

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        • Dominguez C.E.
        • Rock J.A.
        • Horowitz I.R.
        Surgical conditions of the vagina and urethra.
        in: Rock J.A. Jones III, H.W. Te Linde's operative gynecology. 10th ed. Lippincott Williams & Wilkins, Philadelphia, PA2011: 508-511
        • Mandava A.
        • Prabhakar R.R.
        • Smitha S.
        OHVIRA syndrome (obstructed hemivagina and ipsilateral renal anomaly) with uterus didelphys, an unusual presentation.
        J Pediatr Adolesc Gynecol. 2012; 25: e23
        • Khan Z.A.
        • Rajesh U.
        • Rastogi P.
        • et al.
        Imperforate hymen: a rare case of secondary amenorrhoea.
        J Obstet Gynecol. 2011; 31: 91
        • Onan M.A.
        • Turp A.B.
        • Taskiran C.
        • et al.
        Spontaneous closure of the hymen during pregnancy.
        Am J Obstet Gynecol. 2005; 193: 889
        • Ugburo A.O.
        • Fadeyibi I.O.
        • Oluwole A.A.
        • et al.
        The epidemiology and management of gynatresia in Lagos, southwest Nigeria.
        Int J Gynecol Obstet. 2012; 118: 231
        • Bakos O.
        • Berglund L.
        Imperforate hymen and ruptured hematosalpinx: a case report with a review of the literature.
        J Adolesc Health. 1999; 24: 226
        • Kurdoglu Z.
        • Kurdoglu M.
        • Kucukaydin Z.
        Spontaneous rupture of the imperforate hymen in an adolescent girl with hematocolpometra.
        ISRN Obstet Gynecol. 2011; 2011: 520304
        • Zurawin R.K.
        • Dietrich J.E.
        • Heard M.J.
        • et al.
        Didelphic uterus and obstructed hemivagina with renal agenesis: case report and review of the literature.
        J Pediatr Adolesc Gynecol. 2004; 17: 137