Hematocolpos

Case contributed by Dr Alexandra Stanislavsky

Presentation

Constipation.

Patient Data

Age: 12 years
Gender: Female
Ultrasound

There is an elongated, distended structure located in the midline directly posterior to the bladder, with internal low level echoes. The uterus is identified in continuity with the upper end, confirming this to represent a markedly distended vaginal vault. 

Case Discussion

Typical appearance of a hematocolpos.  In a young adolescent patient this is most likely due to an imperforate hymen, however a vaginal septum should be looked for as a differential, either as an isolated abnormality or in association with Mullerian duct anomalies.  There was no evidence of a vaginal septum in this case.

The mass effect caused by the hematocolpos was likely the cause of the patient's constipation - which was the sole presenting complaint.

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