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A Rare Pelvic "Mass-Querader": Acute Urinary Retention Secondary to Hematocolpos in a Preadolescent Patient.
Mil Med. 2020 12 30; 185(11-12):2171-2172.MM

Abstract

We report a case of acute urinary retention in an adolescent female secondary to hematocolpos. A 13-year-old female presented to the emergency department with acute urinary retention and suprapubic abdominal pain for 24 hours. She denied menstruation or sexual history. Bedside bladder ultrasound scan revealed 1.2 L of retained urine and a Foley catheter was placed. A formal renal ultrasound detected a debris-filled structure in the abdomino-pelvic cavity. Follow-up computed tomography of the abdomen and pelvis revealed an 8.5 cm × 9.3 cm × 12.1 cm mass-like structure in the pelvis. No formal pelvic exam was completed and the patient was taken to the operating room for exploratory laparotomy due to concern for large pelvic mass versus tubo-ovarian abscess. However, upon entering the abdominal cavity, no mass was found. At that point, an external genital exam was performed, revealing an imperforate hymen. Hymenotomy resulted in the evacuation of 2.5 L of clotted blood from the vagina and uterus. Hematocolpos resulting in acute urinary retention is exceedingly rare; however, it is an important differential diagnosis that can be ruled in or out by physical exam findings. Although it may be uncomfortable for adolescent patients and physicians, external genital exams should be conducted in young females with acute urinary retention and amenorrhea to evaluate for imperforate hymen. This can ensure appropriate treatment and avoidance of unnecessary invasive procedures.

Authors+Show Affiliations

Department of Family Medicine, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, 4700 N Las Vegas Blvd, Las Vegas, NV 89191.Department of Emergency Medicine, University Nevada Las Vegas, 901 Rancho Lane St 135, Las Vegas, NV 89106.Department of Family Medicine, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, 4700 N Las Vegas Blvd, Las Vegas, NV 89191.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32729932

Citation

Bezjian Wallace, Laurie, et al. "A Rare Pelvic "Mass-Querader": Acute Urinary Retention Secondary to Hematocolpos in a Preadolescent Patient." Military Medicine, vol. 185, no. 11-12, 2020, pp. 2171-2172.
Bezjian Wallace L, Wallace P, Herness J. A Rare Pelvic "Mass-Querader": Acute Urinary Retention Secondary to Hematocolpos in a Preadolescent Patient. Mil Med. 2020;185(11-12):2171-2172.
Bezjian Wallace, L., Wallace, P., & Herness, J. (2020). A Rare Pelvic "Mass-Querader": Acute Urinary Retention Secondary to Hematocolpos in a Preadolescent Patient. Military Medicine, 185(11-12), 2171-2172. https://doi.org/10.1093/milmed/usaa166
Bezjian Wallace L, Wallace P, Herness J. A Rare Pelvic "Mass-Querader": Acute Urinary Retention Secondary to Hematocolpos in a Preadolescent Patient. Mil Med. 2020 12 30;185(11-12):2171-2172. PubMed PMID: 32729932.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Rare Pelvic "Mass-Querader": Acute Urinary Retention Secondary to Hematocolpos in a Preadolescent Patient. AU - Bezjian Wallace,Laurie, AU - Wallace,Patrick, AU - Herness,Joel, PY - 2020/01/30/received PY - 2020/05/15/revised PY - 2020/06/09/accepted PY - 2020/7/31/pubmed PY - 2021/4/10/medline PY - 2020/7/31/entrez SP - 2171 EP - 2172 JF - Military medicine JO - Mil Med VL - 185 IS - 11-12 N2 - We report a case of acute urinary retention in an adolescent female secondary to hematocolpos. A 13-year-old female presented to the emergency department with acute urinary retention and suprapubic abdominal pain for 24 hours. She denied menstruation or sexual history. Bedside bladder ultrasound scan revealed 1.2 L of retained urine and a Foley catheter was placed. A formal renal ultrasound detected a debris-filled structure in the abdomino-pelvic cavity. Follow-up computed tomography of the abdomen and pelvis revealed an 8.5 cm × 9.3 cm × 12.1 cm mass-like structure in the pelvis. No formal pelvic exam was completed and the patient was taken to the operating room for exploratory laparotomy due to concern for large pelvic mass versus tubo-ovarian abscess. However, upon entering the abdominal cavity, no mass was found. At that point, an external genital exam was performed, revealing an imperforate hymen. Hymenotomy resulted in the evacuation of 2.5 L of clotted blood from the vagina and uterus. Hematocolpos resulting in acute urinary retention is exceedingly rare; however, it is an important differential diagnosis that can be ruled in or out by physical exam findings. Although it may be uncomfortable for adolescent patients and physicians, external genital exams should be conducted in young females with acute urinary retention and amenorrhea to evaluate for imperforate hymen. This can ensure appropriate treatment and avoidance of unnecessary invasive procedures. SN - 1930-613X UR - https://www.unboundmedicine.com/medline/citation/32729932/A_Rare_Pelvic_"Mass-Querader":_Acute_Urinary_Retention_Secondary_to_Hematocolpos_in_a_Preadolescent_Patient. L2 - https://academic.oup.com/milmed/article-lookup/doi/10.1093/milmed/usaa166 DB - PRIME DP - Unbound Medicine ER -