A case of hymenal atresia with hematocolpos and hematometra diagnosed by transabdominal ultrasonography.
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The patient was a 12-year-old girl without menarche. She consulted the pediatrics department because of abdominal pain and constipation. Her symptoms initially improved by a laxative, but she reconsulted the pediatrics department with the same complaints 4 days later. An enema followed by abdominal ultrasonography (USG) was perfomed. USG showed a cystic mass with numerous hyperechoic particles, suggesting a chocolate cyst, that was partly connected to a slightly expanded uterine cavity. Hematocolpos and hematmetra were suspected due to hymenal atresia. She was subsequently referred to our outpatient clinic. Physical examination showed that the hymen was expanded and ostium vaginae was completely closed. In addition, pooling of the fluid was observed through the hymen. The hymenal atresia was diagnosed according to the typical findings. The hymen was punctured and incised in the outpatient clinic and about 300m1 of dark brown fluid was removed. Her symptoms quickly disappeared, and the postoperative general condition and endocrinologic examination were no remarkable. On the 18th postoperative day, USG examination showed no abnormal signs in the vaginal and uterine cavity. On the 42nd postoperative day, the patient had spontaneous menstruation. In this case, no graphic examination techniques other than Xray and USG were necessary to make the diagnosis. In addition, hospitalizaion was unnecessary. We confirmed the usefulness of abdominal USG to detect such disorders in young women. [Adv Obstet Gynecol 51 (6); 562 567, 1999 (H.11.11)]
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