scholarly journals Cryptomenorrhoea due to imperforate hymen: a case report

2019 ◽  
Vol 8 (7) ◽  
pp. 2946
Author(s):  
Romi Bansal ◽  
Priyanka . ◽  
Sneha .
Keyword(s):  
Female Genital Tract ◽  
Lower Abdominal Pain ◽  
Tanner Stage ◽  
Urogenital Sinus ◽  
Imperforate Hymen ◽  
Satisfactory Condition ◽  
Stage 4 ◽  
Complete Failure ◽  
Axillary Hair

Imperforate hymen is a rare obstructive congenital anomaly of the female genital tract which arises as a result of complete failure of canalisation of the inferior end of the vaginal plate at the junction between the urogenital sinus and the vagina. Its prevalence is 0.05%-0.1%. We are presenting a case of 14 years old girl who came with complaints of lower abdominal pain since 10 days not associated with nausea, vomiting and diarrhoea. She had not attained menarche but her secondary sexual characters were developed with breast, pubic and axillary hair in tanner stage 4. MRI revealed hematocolpos and hematometra with imperforate hymen. Hymenotomy was performed and 300-400 ml of thick tarry colour blood was drained. Her postoperative period was uneventful, and patient was discharged in satisfactory condition. On follow up after 1 month, patient resumed normal menses.

scholarly journals A Rare Case of Imperforate Hymen Presenting with Perineal Pain

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Zacharis K ◽  
◽  
Klimatsouda M ◽  
Donoudis C ◽  
Valasoulis G ◽  
...  
Keyword(s):  
Adolescent Girl ◽  
Reproductive Tract ◽  
Lower Abdominal Pain ◽  
Female Reproductive Tract ◽  
Perineal Pain ◽  
Effective Management ◽  
Imperforate Hymen ◽  
Menstrual Cycles ◽  
Delayed Treatment

Introduction: Imperforate hymen is a rare local fusion anomaly of the female reproductive tract and diagnosis can be easily missed. Cyclic lower abdominal pain and amenorrhea are common symptoms in cases left untreated after menarche. Perineal pain may be an unusual presenting symptom of imperforate hymen. In order to avert complications related to delayed treatment, hymenotomy is considered effective management. Case Report: We herein describe a case of a 13-year-old adolescent girl with an imperforate hymen presenting with lower abdominal and perineal pain. The girl underwent and hymenotomy and postoperative period was uneventful. Perineal and pelvic pain relieved instantly after surgical treatment and during follow up her menstrual cycles were regular.

scholarly journals Imperforate Hymen

2014 ◽  
Vol 2 (1) ◽  
pp. 52-53
Author(s):  
Krishna Dahiya ◽  
Pushpa Dahiya ◽  
Shaveta Jain ◽  
Nupur LNU
Keyword(s):  
South Asian ◽  
Adolescent Girls ◽  
Female Genital Tract ◽  
Lower Abdominal Pain ◽  
Conclusive Evidence ◽  
Imperforate Hymen ◽  
Delay In Diagnosis ◽  
Presenting Symptoms ◽  
Proper Diagnosis ◽  
Female Genital

ABSTRACT Imperforate hymen is relatively rare but it is the most frequently encountered of the mulleriananomalies of the female genital tract with an incidence of about 0.1%. The clinical presentation varies significantly from patient to patient depending on the age at diagnosis but in most cases, the diagnosis is missed in early childhood delaying the diagnosis upto puberty, when the patient presents with hematocolpos, hematometra or both. When this happens, the presentation could even be misleading because of unlikely presenting symptoms like, urinary retention and bowel obstruction leading to unnecessary urology and gastroenterology referral without any conclusive evidence of the condition furthering the delay in diagnosis and increasing the presentation with complications. This case is an illustration that there is quite often a considerable delay before a proper diagnosis is reached. The aim of this communication is to increase awareness of imperforate hymen among clinicians examining adolescent girls with lower abdominal pain. How to cite this article Dahiya P, Dahiya K, Jain S, Nupur. Imperforate Hymen. J South Asian Feder Menopause Soc 2014;2(1):52-53.

Clinical Analysis of Primary Primitive Neuroectodermal Tumors in the Female Genital Tract

2014 ◽  
Vol 24 (3) ◽  
pp. 404-409 ◽  
Author(s):  
Changji Xiao ◽  
Jing Zhao ◽  
Peng Guo ◽  
Dan Wang ◽  
Dachun Zhao ◽  
...  
Keyword(s):  
Genital Tract ◽  
Female Genital Tract ◽  
Clinical Manifestations ◽  
Neuron Specific Enolase ◽  
Lower Abdominal Pain ◽  
Primitive Neuroectodermal Tumors ◽  
Pathologic Features ◽  
Neuroectodermal Tumors ◽  
Female Genital

ObjectiveThe aim of the study was to investigate the clinical manifestations, diagnosis, treatment, and prognosis of primitive neuroectodermal tumors (PNETs) in the female genital tract.MethodsFrom April 2001 to May 2013, the clinicopathologic characteristics, treatments, outcomes, and prognosis of 11 patients with PNET in the female genital tract were analyzed retrospectively at our hospital.ResultsThe location of PNET in the 11 patients presented here included vulva (2 patients), cervix (2 patients), uterus and its ligament (5 patients), and the ovaries (2 patients). Ages ranged from 18 to 59 years (median, 31 years).The main clinical manifestations of PNET in the female genital tract are irregular vaginal bleeding (6 patients), pelvic mass, uterine enlargement, and rapidly increasing vulvar mass (8 patients), and vulvar pain and lower abdominal pain (5 patients). The CA125 levels of 8 patients were elevated before the operations and reduced to normal when the diseases were controlled, while the levels increased as the tumor was progressive. Results for the most commonly used immunohistochemistry studies revealed CD99 in 11 of the 11 tumors, synaptophysin in 6 of the 7 positive tumors, and neuron-specific enolase in 6 of the 6 tumors. Ten patients underwent surgical resection. Nine of them underwent preoperative or/and postoperative combination chemotherapy. The follow-up of 10 patients were available and ranged from 1 to 145 months (median, 30.5 months), 3 of whom experiencing recurrence.ConclusionsPrimitive neuroectodermal tumor is very rare and can originate from any part of the female genital tract. The tumors had different manifestations but the same pathologic features. CA125 may be an important marker for prognosis and follow-up of PNET of the female internal genital tract.

scholarly journals Sonographic presentation acute hematometra and massive hematocolpos in a pubertal girl: A case report

2020 ◽  
Vol 7 (2) ◽  
pp. 58-63
Author(s):  
Adam Moyosore Afodun ◽  
Victor Okoliko Ukwenya ◽  
Khadijah Kofoworola Quadri ◽  
Raymond Joseph Malinga ◽  
Octovius Ahimbisibwe ◽  
...  
Keyword(s):  
Physical Examination ◽  
Lower Abdominal Pain ◽  
Pelvic Mass ◽  
Postoperative Recovery ◽  
Urogenital Sinus ◽  
Urine Retention ◽  
Imperforate Hymen ◽  
Acute Urine Retention ◽  
Sexual Characteristics ◽  
High Degree

Background: Imperforate hymen is an uncommon obstructive congenital anomaly of the female external reproductive channel due to lack of canalization (lower) vaginal plate between the vaginal and urogenital sinus; with a prevalence rate of less < 0.1%. Hematocolpos / imperforate hymen with heamatometra often presents as a pelvic mass that compresses the urinary bladder causing acute urine retention and pain. Case presentation: A 14-year-old presented with lower abdominal pain for 5 months. Patient physical examination revealed normal secondary sexual characteristics with a thickened than normal hymen. She presented with delayed menarche; a physician earlier prescribed analgesic and anthelmintic medication for pain management. After conservative hymenotomy about 360ml of dark-tan haem (blood) was drained in few minutes. Postoperative recovery was uneventful; normal menstruation occurred after 4 weeks.   Conclusion: Diagnosis through physical examination and ultrasound requires vigilance and a high degree of suspicion; virginity sparing is a viable treatment option due to social reasons and religious beliefs.

scholarly journals Imperforate hymen: a rare cause of tenesmus

2020 ◽  
Vol 19 (3) ◽  
pp. 145-148
Author(s):  
Konstantinos Zacharis ◽  
Stavros Kravvaritis ◽  
Eleni Chrysafopoulou ◽  
Theodoros Charitos ◽  
Anastasia Fouka
Keyword(s):  
Abdominal Pain ◽  
Reproductive Tract ◽  
Gastrointestinal Symptoms ◽  
Lower Abdominal Pain ◽  
Female Reproductive Tract ◽  
Imperforate Hymen ◽  
Gynecological Examination ◽  
Atypical Clinical Presentation ◽  
Late Treatment

Imperforate hymen is an uncommon obstructive anomaly of the female reproductive tract for which early diagnosis is easy to miss. Untreated cases after menarche may cause cyclic lower abdominal pain and amenorrhea. Hymenotomy is considered proper management in order to avoid complications associated with late treatment. We report a case of an imperforate hymen in a 13-year-old adolescent girl presenting with tenesmus and acute lower abdominal pain. The patient was treated with hymenotomy and postoperative period was uneventful. Tenesmus and lower abdominal pain resolved immediately after surgery and during follow up the girl reported normal menstrual cycles. According to our case, tenesmus may be an atypical clinical presentation of imperforate hymen. Therefore, imperforate hymen should not be eliminated from differential diagnosis when it comes to adolescent females with abdominal pelvic pain and gastrointestinal symptoms and gynecological examination should be performed.

scholarly journals Virginity-sparing management of hematocolpos with imperforate hymen: case report and literature review

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984676
Author(s):  
Thomas Obinchemti Egbe ◽  
Fidelia Mbi Kobenge ◽  
Emmanuella Manka’a Wankie
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Lower Abdominal Pain ◽  
Pelvic Mass ◽  
Urogenital Sinus ◽  
Primary Amenorrhea ◽  
Abdominal Ultrasonography ◽  
Imperforate Hymen ◽  
History Of ◽  
Good Treatment Option

Imperforate hymen results from failure of the endoderm of the urogenital sinus to completely canalize and has an incidence of 0.01% to 0.05%. This sometimes presents as a pelvic mass that compresses the bladder causing acute urinary retention. A 13-year-old girl was referred to our department with a history of primary amenorrhea, cyclic lower abdominal pain, abdominal–pelvic mass, constipation and acute urinary retention. She had an ultrasonography misdiagnosis of a huge ovarian mass before referral to our unit. On examination, the vagina was bulging and compressing the rectum. Repeat abdominal ultrasonography confirmed the diagnosis of hematometrocolpos. She underwent X-shaped hymenotomy with a favorable outcome. Diagnosis of imperforate hymen requires high suspicion index. Virginity-sparing surgery constitutes a good treatment option for cultural and religious reasons.

scholarly journals Neglected congenital adrenal hyperplasia presenting as recurrent abdominal pain

2020 ◽  
Vol 8 (2) ◽  
pp. 45-46
Author(s):  
Isaac Oludare Oluwayemi ◽  
Oyebanji AH ◽  
Omowaye MT
Keyword(s):  
Abdominal Pain ◽  
Congenital Adrenal Hyperplasia ◽  
Elevated Serum ◽  
Lower Abdominal Pain ◽  
Autosomal Recessive Disorder ◽  
Tanner Stage ◽  
Bone Age ◽  
Urogenital Sinus ◽  
Normal Female ◽  
Adrenal Hyperplasia

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder with the incidence of the classic type being 1:15,000 births worldwide. It results from defective synthesis of steroid hormones because of deficiency of one of the five enzymes required for synthesis of cortisol. Cases of severe forms of CAH are often missed in developing countries where there is no program for newborn screening with many of them dying in neonatal periods. Management of the mild forms are also hindered or delayed because of superstitions, ignorance and poverty. We present an 11years old girl who presented with abnormal genital since birth and recurrent monthly lower abdominal pain of eight month duration. She had Tanner stage 4 breasts, normal female pubic hair distribution, clitoromegaly, fused scrotalized labia with urogenital sinus and absent vaginal opening. Abdominal ultrasound showed normal female reproductive organs; she had advanced bone age of 16years and elevated serum 17-hydroxyprogesterone level. She’s being worked up for possible genitoplasty.

scholarly journals Spectrum of Etiologies Causing Hydrometrocolpos

2013 ◽  
Vol 2 (1) ◽  
pp. 5
Author(s):  
Ayşenur Cerrah Celayir ◽  
Gökmen Kurt ◽  
Ceyhan Şahin ◽  
Inanç Cici
Keyword(s):  
Treatment Options ◽  
Urogenital Sinus ◽  
Vaginal Septum ◽  
Imperforate Hymen ◽  
Incision And Drainage ◽  
Persistent Cloaca ◽  
Transverse Vaginal Septum ◽  
Initial Procedure ◽  
Cloacal Malformations

Background: Hydrometrocolpos (HMC) develops as a result of vaginal outflow obstruction and the accumulation of secretions. It might be secondary to persistent cloaca, urogenital sinus, some syndromes, presence of the vaginal septum, vaginal atresia, and imperforate hymen. Each of them has different treatment options and follow-up protocols. This study was performed to identify the etiology and the related management of patients with HMC.Materials and Methods: A descriptive series of patients with HMC managed in our hospital between 2004 and 2011 is being presented. The medical record of these patients was analyzed for etiology, management, and outcome.Results: Eight patients with HMC were managed during 7 years at our department. Underlying etiologies included urogenital sinus (n=3), and 1 each of imperforate hymen, transverse vaginal septum, Herlyn-Werner-Wunderlich syndrome, persistent cloaca, and a variant of the cloaca. Four patients were prenatally diagnosed. The patient with imperforate hymen was managed successfully with incision and drainage. Abdominal vaginostomy was done in three patients with urogenital sinus as initial procedure. In patient with persistent cloaca, a colostomy and abdominal vaginostomy were performed. Patient with cloaca variant died due to persistent acidosis and salt wasting.Conclusion: HMC may have different etiological factors which may dictate different surgical management. Etiology of HMC can be as simple as imperforate hymen to the most severe cloacal malformations.

scholarly journals Cervical Mesonephric Adenocarcinoma: A Case Report of a Rare Gynecological Tumor from Embryological Remains of the Female Genital Tract

2021 ◽  
Author(s):  
Catarina Reis-de-Carvalho ◽  
Carolina Vaz-de-Macedo ◽  
Santiago Ortiz ◽  
Anabela Colaço ◽  
Carlos Calhaz-Jorge
Keyword(s):  
Case Report ◽  
Genital Tract ◽  
Female Genital Tract ◽  
Treatment Protocol ◽  
Gynecology And Obstetrics ◽  
Mesonephric Adenocarcinoma ◽  
Gynecological Tumor ◽  
Cervical Adenocarcinomas ◽  
Female Genital

Abstract Introduction Malignant mesonephric tumors are uncommon in the female genital tract, and they are usually located where embryonic remnants of Wolffian ducts are detected, such as the uterine cervix. The information about these tumors, their treatment protocol, and prognosis are scarce. Case report A 60-year-old woman with postmenopausal vaginal bleeding was initially diagnosed with endometrial carcinoma. After suspicion co-testing, the patient underwent a loop electrosurgical excision of the cervix and was eventually diagnosed with mesonephric adenocarcinoma. She was subjected to a radical hysterectomy, which revealed International Federation of Gynecology and Obstetrics (FIGO) IB1 stage, and adjuvant radiotherapy. The follow-up showed no evidence of recurrence after 60 months. Conclusion We present the case of a woman with cervical mesonephric adenocarcinoma. When compared with the literature, this case had the longest clinical follow-up without evidence of recurrence, which reinforces the concept that these tumors are associated with a favorable prognosis if managed according to the guidelines defined for the treatment of patients with cervical adenocarcinomas. Though a rare entity, it should be kept in mind as a differential diagnosis for other cervical cancers.

Long-term follow-up of differentiated thyroid carcinoma in children and adolescents

2020 ◽  
Vol 33 (11) ◽  
pp. 1431-1441
Author(s):  
Montserrat Negre Busó ◽  
Amparo García Burillo ◽  
Marc Simó Perdigó ◽  
Pere Galofré Mora ◽  
Maria Boronat de Ferrater ◽  
...  
Keyword(s):  
Complete Remission ◽  
Thyroid Carcinoma ◽  
Children And Adolescents ◽  
Differentiated Thyroid Carcinoma ◽  
Radioiodine Treatment ◽  
Persistent Disease ◽  
Stage 4 ◽  
Long Term Follow Up

AbstractObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences.ConclusionsDTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.

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