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Pelvis » Female Pelvis (Gynecology)
Hematometrocolpos
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Author(s) :
Fazeel-Uz Zaman, MD
 
Presentation This 16 year old female presented with a history of primary amenorrhoea, monthly lower abominal pains and a palpable mass in the lower abdomen.
 
 
 
Caption: Sagittal lower abdomen.
Description: Longitudinal section showing uterus and upper vagina.
 
 
 
Caption: Sagittal pelvis
Description: Longitudinal section showing distended vagina.
 
 
 
Caption: Transverse pelvis.
Description: Transverse section through vagina.
 
 
 
Caption: Transverse oblique section.
Description: Tranverse section of uterus angulated in coronal fashion to show ditended uterus (fundus, body & cervix.
 
Differential Diagnosis Hematometrocolpos
Pelvic or abdominal neoplasm
 
Final Diagnosis Hematometrocolpos
 
Discussion On ultrasound the uterus and vagina are distended with fluid showing low level echoes with posterior enhancement. The uterine wall is thicker than the vaginal wall and the vagina appears more distended. Based on patient age and clinical history, and the classic findings of dilated fluid filled vagina and uterus, the diagnosis was hematometrocolpos due to imperforate hymen.
 
Follow Up The patient was referred to a gynecologist who confirmed the diagnosis.
 
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