Imperforate hymen is a congenital condition in which the hymen is without a normal central opening.

0.1% of patients, usually isolated findings

Primary amenorrhea with cyclic lower abdominal pain during menarche age. Imperforate hymen can be diagnosed at physical examination upon identification of a bulging, bluish membrane that allows positive transillumination at the introitus; consequently, imaging is rarely indicated

Failure of the recanalization process of the distal end of the vagina. The hymen indicates the junction between the urogenital sinus and sino-vaginal bulb. Imperforate hymen occurs due to a failure of recanalization of this membranous vestige.

Ultrasound

Usual initial imaging modality of diagnosis

  • distended fluid-filled vagina (hematocolpos) and uterus (hematometra) with internal echoes
MRI

Signal changes follow subcute bleeding episodes and the blood products in hematocolpometra:

  • T1: hyperintense endometrial fluid extending down to the level of the hymen
  • T2: hypointense endometrial fluid extending down to the level of the hymen
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Article information

rID: 33505
System: Urogenital
Section: Pathology
Synonyms or Alternate Spellings:

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Cases and figures

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    Case 1: with hematometrocolpos
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    Case 2: with ueterus didelphys
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