Imperforate hymen mimicking acute appendicitis in an adolescent woman: a rare presentation

2021 ◽  
Vol 14 (3) ◽  
pp. e238547
Author(s):  
Victoria Rose Russell ◽  
Mohamed Ibrahim ◽  
Georgina Phillips ◽  
Tom Setchell ◽  
Sanjay Purkayastha
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Female Genital Tract ◽  
Delayed Diagnosis ◽  
Rare Presentation ◽  
Left Iliac Fossa ◽  
Imperforate Hymen ◽  
Retrograde Menstruation ◽  
Low Incidence

Imperforate hymen is a rare congenital malformation of the female genital tract. The condition poses several diagnostic challenges owing to its low incidence and often atypical presentation. Classical symptoms include amenorrhoea and cyclical abdominal pain. Delayed diagnosis leads to potentially irreversible and lifechanging sequelae including infertility, endometriosis and renal failure. A premenarchal 13-year-old girl with a background of chronic constipation presented with symptoms mimicking acute appendicitis. The underlying cause was imperforate hymen and retrograde menstruation. The diagnosis was made during diagnostic laparoscopy. As with this patient, pre-existing symptoms are often troublesome long before the true diagnosis is made. This case report highlights the importance of recognising imperforate hymen as a potential cause of acute abdominal pain in premenarchal adolescent girls. The clinical picture may present as right or left iliac fossa pain. Early identification reduces the risk of adverse complications and avoids unnecessary and potentially harmful interventions.

scholarly journals Could MicroRNAs Be Useful Tools to Improve the Diagnosis and Treatment of Rare Gynecological Cancers? A Brief Overview

2021 ◽  
Vol 22 (8) ◽  
pp. 3822
Author(s):  
Riccardo Di Fiore ◽  
Sherif Suleiman ◽  
Francesca Pentimalli ◽  
Sharon A. O’Toole ◽  
John J. O’Leary ◽  
...  
Keyword(s):  
Female Genital Tract ◽  
Germ Cell Tumors ◽  
Delayed Diagnosis ◽  
Public Health Issue ◽  
Gene Promoters ◽  
Gynecological Cancers ◽  
High Incidence ◽  
Low Incidence ◽  
Diagnosis Therapy ◽  
Malignant Germ Cell Tumors

Gynecological cancers pose an important public health issue, with a high incidence among women of all ages. Gynecological cancers such as malignant germ-cell tumors, sex-cord-stromal tumors, uterine sarcomas and carcinosarcomas, gestational trophoblastic neoplasia, vulvar carcinoma and melanoma of the female genital tract, are defined as rare with an annual incidence of <6 per 100,000 women. Rare gynecological cancers (RGCs) are associated with poor prognosis, and given the low incidence of each entity, there is the risk of delayed diagnosis due to clinical inexperience and limited therapeutic options. There has been a growing interest in the field of microRNAs (miRNAs), a class of small non-coding RNAs of ∼22 nucleotides in length, because of their potential to regulate diverse biological processes. miRNAs usually induce mRNA degradation and translational repression by interacting with the 3′ untranslated region (3′-UTR) of target mRNAs, as well as other regions and gene promoters, as well as activating translation or regulating transcription under certain conditions. Recent research has revealed the enormous promise of miRNAs for improving the diagnosis, therapy and prognosis of all major gynecological cancers. However, to date, only a few studies have been performed on RGCs. In this review, we summarize the data currently available regarding RGCs.

scholarly journals Amyand's hernia and acute appendicitis: Case presentation in Basic Hospital of Chone

2020 ◽  
Vol 4 (2) ◽  
pp. 19-23
Author(s):  
Orelvis Rodríguez Palmero ◽  
Liseidy Ordaz Marin ◽  
María Del Rosario Herrera Velázquez ◽  
Agustín Marcos García Andrade
Keyword(s):  
Abdominal Pain ◽  
Inguinal Hernia ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
Iliac Fossa ◽  
Amyand’S Hernia ◽  
Case Presentation ◽  
The North ◽  
History Of ◽  
The Right

Present the case of a 66-year-old male patient, with a history of right inguinal hernia, who was referred to the emergency room at the IESS de Chone Basic Hospital in the north of the Manabí province, Ecuador, with symptoms of Abdominal pain of more than 24 hours of evolution located in the right iliac fossa and inguinal region on the same side, in the physical examination the hernia was impossible to reduce, so he was taken to the operating room, in the intervention the cecal appendix was found swollen within the hernial sac, a condition known as Amyand's hernia.

scholarly journals Pelvic pain in young girls: not only dysmenorrhoea!

2018 ◽  
pp. bcr-2018-226041
Author(s):  
Vera Furtado Veiga ◽  
Barbara Ribeiro ◽  
Hermínia Afonso ◽  
Isabel Reis
Keyword(s):  
Abdominal Pain ◽  
Pelvic Pain ◽  
Urinary Symptoms ◽  
Imperforate Hymen ◽  
Retrograde Menstruation ◽  
Young Girls ◽  
Gynaecological Examination ◽  
Rare Malformation ◽  
Vaginal Distension

Imperforate hymen is the most frequent cause of haematocolpos, although it is a rare malformation (1:2000). We present two cases of young girls with cyclic abdominal pain and urinary symptoms. At gynaecological examination, they all presented imperforate hymen and ultrasound revealed significant vaginal distension. X-shaped hymenectomy was performed in all patients. The later the diagnosis of imperforate hymen, the higher the risk of complications like haematometra, haematosalpinx, haemoperitoneum and infections such as tubo-ovarian abscesses, peritonitis and endometriosis (retrograde menstruation theory).

scholarly journals Omental infarction in an obese 10-year-old boy

2011 ◽  
Vol 3 (3) ◽  
pp. 22 ◽  
Author(s):  
Katerina Kambouri ◽  
Stefanos Gardikis ◽  
Alexandra Giatromanolaki ◽  
Aggelos Tsalkidis ◽  
Efthimios Sivridis ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Preoperative Diagnosis ◽  
Acute Abdominal Pain ◽  
Accurate Diagnosis ◽  
Lower Abdomen ◽  
Omental Infarction ◽  
Appropriate Treatment ◽  
Low Incidence ◽  
The Right

Primary omental infarction (POI) has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US) examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

scholarly journals Tuboovarian Abscess as Primary Presentation for Imperforate Hymen

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Jeh Wen Ho ◽  
D. Angstetra ◽  
R. Loong ◽  
T. Fleming
Keyword(s):  
Iliac Fossa ◽  
Rare Event ◽  
First Episode ◽  
Left Iliac Fossa ◽  
Imperforate Hymen ◽  
Incision And Drainage ◽  
Tuboovarian Abscess ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Objective.Imperforate hymen represents the extreme in the spectrum of hymenal embryological variations. The archetypal presentation in the adolescent patient is that of cyclical abdominopelvic pain in the presence of amenorrhoea. We reported a rare event of imperforate hymen presenting as a cause of tuboovarian abscess (TOA).Case Study.A 14-year-old girl presented to the emergency department complaining of severe left iliac fossa pain. It was her first episode of heavy bleeding per vagina, and she had a history of cyclical pelvic pain. She was clinically unwell, and an external genital examination demonstrated a partially perforated hymen. A transabdominal ultrasound showed grossly dilated serpiginous fallopian tubes. The upper part of the vagina was filled with homogeneous echogenic substance. Magnetic resonance imaging (MRI) demonstrated complex right adnexa mass with bilateral pyo-haemato-salpinges, haematometra, and haematocolpos. In theatre, the imperforate hymen was opened via cruciate incision and blood was drained from the vagina. At laparoscopy, dense purulent material was evacuated prior to an incision and drainage of the persistent right TOA.Conclusion.Ideally identification of imperforate hymen should occur during neonatal examination to prevent symptomatic presentation. Our case highlights the risks of late recognition resulting in the development of sepsis and TOA.

scholarly journals ACUTE APPENDICITIS

2016 ◽  
Vol 23 (03) ◽  
pp. 241-245
Author(s):  
Javeria Farid ◽  
Rizwanullah Junaid Bhambhro ◽  
Sohail Soomro
Keyword(s):  
Abdominal Pain ◽  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Epigastric Pain ◽  
Iliac Fossa ◽  
University Hospital ◽  
Cross Sectional ◽  
Clinical Pattern ◽  
Rebound Tenderness ◽  
Right Iliac Fossa Pain

Objectives: To determine the clinical presenting pattern and postoperativecomplications of acute appendicitis. Study design: Observational and cross-sectional study.Setting: Isra university hospital Hyderabad. Period: 7 months. Methodology: All the patientsabove 12 years of age and both genders male/female after diagnosis of acute appendicitishad integrated in the study. Complete clinical pattern and postoperative complications hadrecorded. Results: Symptoms/sign nausea, vomiting, anorexia, rebound tenderness, fever,constipation, diarrhea and leukocytosis were noted with the percentage 98.0%, 65.0%, 95.0%,90.0%, 85.0%, 58.0%, 30.0% and 89.0% respectively. Paraumblical pain was noted in 50.0%of the cases, right iliac fossa pain was in the 99.0%, epigastric pain was seen in 61.0% and theother abdominal pain was noted in the 39.0%. Postoperative complications found in 33.0% ofthe cases and majority was seen wound infection. Conclusion: In the conclusion of this studyclinical features nausea, vomiting, anorexia, rebound tenderness, fever, and leukocytosis wereseen as most common and the most important postoperative complication is infection whichprobably created with the uncompleted sterilization.

scholarly journals Unruptured ectopic pregnancy in rudimentary horn of unicornuate uterus at fourteen weeks with previous vaginal delivery

2020 ◽  
Vol 9 (12) ◽  
pp. 5166
Author(s):  
Jaydip Hindocha ◽  
Sneh Sonaiya
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Peritoneal Lavage ◽  
Iliac Fossa ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
Left Iliac Fossa ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Mullerian Ducts

Unicornuate uterus with a rudimentary horn is an anomaly of the mullerian duct and is an extremely rare condition. This condition results when one of the paired mullerian ducts fails to fuse completely. Its incidence is estimated to be one in 76,000 pregnancies.Pregnancy in the rudimentary horn of the unicornuate uterus is difficult to diagnose on ultrasound and can be easily missed out. Hence the pregnancy usually gets detected after rupture when the mother presents with the complaint of severe abdominal pain. This is a case report of a 24 year old G2P1A0L1 female who presented to us with complaints of tenderness in the left iliac fossa and mild abdominal distention. Clinical examinations, radiological investigations, and exploratory laparotomy revealed a unicornuate uterus with an unruptured left rudimentary horn pregnancy at 14 weeks with mild hemoperitoneum. Following the exploratory laparotomy, excision of the left rudimentary horn and thorough peritoneal lavage was performed.

scholarly journals Histiocytic Necrotizing Lymphadenitis Mimicking Acute Appendicitis in a Child: A Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Chun-Zhen Hua ◽  
Yu-Kai Chen ◽  
Shun-Zhi Chen ◽  
Wei-Zhong Gu ◽  
Qiang Shu
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Pathological Examination ◽  
Recurrent Fever ◽  
Histiocytic Necrotizing Lymphadenitis ◽  
Mesenteric Lymph Nodes ◽  
Case Presentation ◽  
Necrotizing Lymphadenitis ◽  
Low Incidence

Background: Histiocytic necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease (KFD), is a self-limiting inflammatory disease with low incidence and high misdiagnosis rate in children. Furthermore, cases where the clinical presentation resembles acute appendicitis are very rare.Case Presentation: A 14-year-old boy was misdiagnosed as acute appendicitis and received operative treatment at his early visit. He suffered from abdominal pain, vomiting, diarrhea, fever, and lymphadenitis at the ileocecal junction, which were found by B-ultrasonography examination and surgery. Lymphadenectomy, as well as appendectomy, was performed, and KFD was identified by pathological examination. The patient was transferred to our hospital for further therapy because of recurrent fever and abdominal pain after the appendectomy. His temperature became normal after methylprednisolone was administered, and no recurrence was observed till now during follow-up.Conclusions: Necrotizing lymphadenitis involving mesenteric lymph nodes may cause acute-appendicitis-like symptom; KFD should be a diagnostic consideration for mesenteric lymphadenitis.

scholarly journals Torsion of caecal appendices epiploicae: mimicking acute appendicitis

2020 ◽  
Vol 7 (7) ◽  
pp. 2407
Author(s):  
A. P. Roshini ◽  
Dattaprasad Samant ◽  
F. P. Noronha
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Free Fluid ◽  
Normal Appendix ◽  
Menstrual Cycles ◽  
Rebound Tenderness ◽  
Appendices Epiploicae ◽  
The Right

Acute appendicitis is a common cause for pain in the right iliac fossa, which requires urgent surgical intervention. However, at the time of surgery, if the appendix is normal, the surgeon has to search for other causes of acute abdominal pain including rare etiologies, such as torsion of appendices epiploicae and subsequently its gangrene. We report the case of a 45 years old female who presented with right lower abdominal pain, rebound tenderness and guarding in right iliac fosse, with regular menstrual cycles and no urinary complaints. Investigation revealed leucocytosis and ultra-sonography abdomen was suggestive of an inflamed appendix in the right iliac fossa with free fluid. Intra-operatively, we found a normal appendix with gangrene of the appendices epiploicae which had undergone torsion. She underwent excision off appendices epiploicae with appendicectomy with uneventful post-operative period. Histopathology of the appendices was suggestive of congestion.  Preoperative diagnosis of this condition is rarely made.

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