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Hematometrocolpos

Case contributed by Dr Pavan Borra

Presentation

Primary amenorrhea with pelvic pain and mass.

Patient Data

Age: 15 years
Gender: Female

Pelvis

MRI

Cervix and vagina are elongated and filled with T1/T2 hyperintense collection. T2 hypointense fluid-fluid levels noted within the collection. Small collection in the uterine cavity. The urinary bladder is displaced to the right side. Both ovaries are normal.

Ultrasound

The cervix and vagina distended with echogenic fluid collection.

Case Discussion

Blood filled uterine, cervical and vaginal cavities suggesting hematometrocolpos.

Imperforate hymen is the cause in this case. Other causes include transverse vaginal septum, vaginal atresia, blind horn of bicornuate uterus.

Differential diagnoses are an ovarian cyst and duplication cyst.

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