Case of the Week - Patient Summary 13387Peer Reviewed and Certified -
• Fluid collection in the pelvis, most consistent with hydrocolpos.
• No evidence of hydrometros.
• constipation
• obstructive uropathy
• pregnancy
• pelvic tumor
• ovarian cyst
• hydrocolpos, hydrometrocolpos
Hydrocolpos secondary to imperforate hymen - LINK -
Key points:
1. Imperforate hymen is the most common anatomic disorder during the pubertal period.
2. Clinical presentation:
• Adolescent female with complaints of vague abdominal pain
• May also present with constipation, urinary retention, and/or back pain
• May be identified in the neonatal period
• Occasionally complain of monthly exacerbations
• History of primary amenorrhea
• Secondary sexual characteristics developed normally
3. Physical exam findings:
• Tenderness and fullness midline on palpation of lower abdomen
• Pelvic exam often revealing bulging of hymen
• Color of hymen commonly described as bluish
4. Radiologic findings:
• Plain films may reveal a midline, lower abdominal mass
• On ultrasound, hydrocolpos appears as echogenic dilation of the vagina
-Tubular midline mass arriving from pelvis
-Mass is cystic appearing
-Echoes scattered (suggesting cellular debris, mucoid material or blood)
-Anatomy of kidneys and uterus also examined for dilation
• MRI with cross-sectional imaging may help identify origin of mass
5. Treatment: Surgery intervention necessary to create patent hymen
PMID: 17924224
PMID: 11706213
PMID: 19118883
PMID: 19064224
