Case contributed by Dr Haytham Mohamed


Lower abdominal distension and pain

Patient Data

Age: 15 years
Gender: Female

The vagina is seen elongated and distended with high signal intensity on T1 weighted images (WIs), low signal on T2 WIs and fat-saturated T1 images shows high signal (no signal suppression) indicating blood. The vagina is displacing the uterus upwards. The endometrial cavity shows a minimal amount of fluid, especially in its lower segment.

Case Discussion

Vertically elongated fluid-filled vaginal cavity with enhancing walls on contrast images (not available in this case) displacing the uterus, urinary bladder, and rectum. The endometrial cavity shows a minimal amount of fluid especially in the lower segment denoting haematometrocolpos most likely due to an imperforate hymen.

Causes of haematometrocolpos include:

  • Imperforate hymen
  • Transverse vaginal septum (mostly between the middle and upper thirds of the vagina)
  • Vaginal stenosis or atresia
  • Cervical stenosis or atresia
  • Mass effect from duplications of the uterus or vagina
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Case information

rID: 59724
Published: 27th Apr 2018
Last edited: 27th Apr 2018
Inclusion in quiz mode: Included
Institution: Mansoura University Hospitals

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