A Rare Case of Massive Hematometra with a Tubo-ovarian Abscess in a 16-year-old Female.

Georgios Tsatsaris,Marianna Theodora,Emmanuel N Kontomanolis,Zacharias Fasoulakis,Ioannis Papapanagiotou

doi:10.7759/cureus.4845

Georgios Tsatsaris, Marianna Theodora + Show 3 more

Open Access

https://doi.org/10.7759/cureus.4845

Copy DOI

Abstract

Imperforate hymen is a congenital defect of the lower genital tract and specifically the vagina. The examination of a neonatal can be quite helpful to avoid a multitude of complications in puberty like hematocolpos and tubo-ovarian abscess.We present the case of a 16-year-old who presented to the emergency department with fever (37.9° C), which was progressive the last two days, swollen abdomen, and pain in the lower abdomen. She also had a one-year history of cyclic abdominal pain. The patient had primary amenorrhea, the secondary sexual characteristics were normal for her age (Tanner III), and there was no family history of primary amenorrhea. The physical and ultrasound examination revealed an imperforate and bulging vaginal membrane and a multilocular adnexal mass, respectively.Every doctor should suspect this medical condition when there is a triad of symptoms like cyclic lower abdominal pain, primary amenorrhea, and swollen abdomen. Early diagnosis of an imperforate hymen can prevent serious complications for young patients.

Highlights

Every doctor should suspect this medical condition when there is a triad of symptoms like cyclic lower abdominal pain, primary amenorrhea, and swollen abdomen
Hematometra is a medical condition that involves the collection of blood in the uterus
The patient had primary amenorrhea, the secondary sexual characteristics were normal for her age (Tanner III), and there was no family history of primary amenorrhea

Summary

Introduction

Hematometra is a medical condition that involves the collection of blood in the uterus. Some of the complications of this medical condition include pelvic infection with tubo-ovarian abscess, obstructive acute renal failure, peritonitis, endometriosis, hematosalpinx, and constipation. The treatment of these patients is surgical, and the standard procedure is hymenectomy. We study the case of a 16-year-old, who came to the emergency department with fever (37.9 °C), progressive over the last two days, swollen abdomen, and pain in the lower abdomen She had a history of cyclic abdominal pain for almost one year. She continued doxycycline per os at 100 mg twice a day for the two weeks

Discussion

Conclusions

Disclosures

Weström L