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Hematometrocolpos Disguised as Abdominal Pain.
J Emerg Med. 2017 Nov; 53(5):e97-e99.JE

Abstract

BACKGROUND

Hematometrocolpos caused by an imperforate hymen is a common form of vaginal outflow obstruction. This is a rare pediatric anomaly that can present with atypical or vague symptomatology, such as abdominal pain or constipation or urinary retention in the setting of amenorrhea. It is essential to obtain a gynecologic history and inquire about menstrual cycles to properly evaluate a young female with such a common complaint as abdominal pain. Failure to perform a gynecologic examination in the emergency department setting may delay diagnosis and appropriate care for this rare condition, which can lead to serious complications.

CASE REPORT

This case describes a 12-year-old female who presented to the emergency department with a complaint of abdominal pain and urinary symptoms. Because of the severity of the patient's pain on abdominal examination, we obtained a computed tomography scan of her abdomen and pelvis, which showed findings consistent with hematometrocolpos. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Obstruction of the female genital outflow tract is a rare occurrence. Because abdominal pain is such a common complaint, not only in the pediatric emergency department but also in the outpatient setting, the diagnosis of hematometrocolpos may easily go undiagnosed for months or even years. Obtaining a complete gynecologic history is key when evaluating young females with abdominal pain or urinary retention. Early detection and timely management can prevent serious complications and long-term sequelae. This patient had a successful outcome and early surgical management of her hematometrocolpos which was caused by an imperforate hymen.

Authors+Show Affiliations

Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, New Jersey.Department of Pediatric Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, New Jersey.Department of Emergency Medicine, Rowan University SOM Kennedy University Hospital, Stratford, New Jersey.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28988737

Citation

Saleh, Ramy, et al. "Hematometrocolpos Disguised as Abdominal Pain." The Journal of Emergency Medicine, vol. 53, no. 5, 2017, pp. e97-e99.
Saleh R, Katzenbach G, Espinosa J. Hematometrocolpos Disguised as Abdominal Pain. J Emerg Med. 2017;53(5):e97-e99.
Saleh, R., Katzenbach, G., & Espinosa, J. (2017). Hematometrocolpos Disguised as Abdominal Pain. The Journal of Emergency Medicine, 53(5), e97-e99. https://doi.org/10.1016/j.jemermed.2017.06.043
Saleh R, Katzenbach G, Espinosa J. Hematometrocolpos Disguised as Abdominal Pain. J Emerg Med. 2017;53(5):e97-e99. PubMed PMID: 28988737.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hematometrocolpos Disguised as Abdominal Pain. AU - Saleh,Ramy, AU - Katzenbach,George,3rd AU - Espinosa,James, Y1 - 2017/10/05/ PY - 2017/04/14/received PY - 2017/05/19/revised PY - 2017/06/28/accepted PY - 2017/10/11/pubmed PY - 2018/7/17/medline PY - 2017/10/10/entrez KW - abdominal pain KW - amenorrhea KW - constipation KW - gynecological examination KW - hematometrocolpos KW - hymenectomy KW - imperforate hymen KW - urinary retention SP - e97 EP - e99 JF - The Journal of emergency medicine JO - J Emerg Med VL - 53 IS - 5 N2 - BACKGROUND: Hematometrocolpos caused by an imperforate hymen is a common form of vaginal outflow obstruction. This is a rare pediatric anomaly that can present with atypical or vague symptomatology, such as abdominal pain or constipation or urinary retention in the setting of amenorrhea. It is essential to obtain a gynecologic history and inquire about menstrual cycles to properly evaluate a young female with such a common complaint as abdominal pain. Failure to perform a gynecologic examination in the emergency department setting may delay diagnosis and appropriate care for this rare condition, which can lead to serious complications. CASE REPORT: This case describes a 12-year-old female who presented to the emergency department with a complaint of abdominal pain and urinary symptoms. Because of the severity of the patient's pain on abdominal examination, we obtained a computed tomography scan of her abdomen and pelvis, which showed findings consistent with hematometrocolpos. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Obstruction of the female genital outflow tract is a rare occurrence. Because abdominal pain is such a common complaint, not only in the pediatric emergency department but also in the outpatient setting, the diagnosis of hematometrocolpos may easily go undiagnosed for months or even years. Obtaining a complete gynecologic history is key when evaluating young females with abdominal pain or urinary retention. Early detection and timely management can prevent serious complications and long-term sequelae. This patient had a successful outcome and early surgical management of her hematometrocolpos which was caused by an imperforate hymen. SN - 0736-4679 UR - https://www.unboundmedicine.com/medline/citation/28988737/Hematometrocolpos_Disguised_as_Abdominal_Pain_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0736-4679(17)30619-4 DB - PRIME DP - Unbound Medicine ER -