Imperforate hymen with hematometrocolpos
Presented with pain lower abdomen, lower abdominal discomfort, and delayed menarche.
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Ultrasound images show two well defined structures communicating with each other through os like opening which are distended with mid level floating echoes showing movement. Both the structures are seen in the pelvis region. The upper of the two fluid filled structures has thick echogenic walls - uterus filled with blood and the lower structure is tubular with thin walls and is seen extending deep into pelvis anterior to rectum - vagina filled with blood.
The patient was reviewed by the referring clinician with a gynaecological physical examination revealing a bulging hymen completely obliterating vaginal opening confirming the diagnosis.