Hymen atresia and the syndrome of incomplete doubling of uterus in 15-years-old girl

Overview

Hymen atresia presents a genital tract outflow obstruction. The blood can not outflow in the menarche, it cumulates in vagina and the haematocolpos develops there. There may also develop a haematometra. The casuistic describes a 15-years-old female patient with anomaly of the external genitalia and hymen atresia. The ultrasound and palpation examination detected the haematocolpos and intravenous urography detected the agenesia of the left kidney. There was indicated the hymen discision and the evacuation of haematocolpos. Approximately six months later, the diagnostic laparoscopy with hysteroscopy was indicated for abdominal pain at the menstruation. It confirmed haematometra in rudimentary left corner and haematosalpinx on the same side. Based on that fact, the laparoscopy was converted into laparotomy and there was made the exstirpation of rudimentary left corner with left salpingectomy. The case confirms that the children’s gynaecologist examination must be an indivisible part of examination algorithm in the abdominal pain and the finding of resistance in small pelvis in the female patients in adolescent period. In that case, not only ovarial pathology, but also the possible inborn genital defects should be considered.

Key words:
hymen atresia – haematocolpos – haematometra – haematosalpinx – menarche – abdominal pain – resistance in small pelvis