Imperforate hymen

Case contributed by Abiola Ayodele
Diagnosis certain

Presentation

Primary amenorrhea, lower abdominal pain and urinary obstruction.

Patient Data

Age: 15 years
Gender: Female
mri
This study is a stack
Sagittal
T2
This study is a stack
Sagittal
T2 fat sat
This study is a stack
Coronal
T2
This study is a stack
Axial
T1
This study is a stack
Axial T1
fat sat
This study is a stack
Axial
T2
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Info

There is a ballooning of the entire vagina and the uterus with hemorrhagic content appearing as hyperintense on T1 and hyperintense on T2 consistent with late subacute bleed. There is a rounding off at the lower vagina at the level of the hymen. The distended vagina exerts significant compression on the urinary bladder anteriorly and the rectum posteriorly. No vaginal septum or associated uterine anomalies.

Case Discussion

Imperforate hymen is a congenital condition in which the hymen lacks a normal opening. It typically presents with primary amenorrhea with cyclic lower abdominal pain during the age of menarche. Imaging findings show hematometrocolpos extending down to the level of the hymen.

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