Abstract
Neonatal hydrometrocolpos is a rare abnormality and can present as an abdominal mass, urinary tract obstruction, anuria, hydroureteronephrosis, constipation or respiratory distress. Hydrometrocolpos in neonate can be due to imperforate hymen, vaginal atresia, vaginal septum, urogenital sinus or even cloaca. Clinical examination and routine ultrasonography cannot differentiate causes of hydrocolpos in all such cases. Surgical approach depends upon the underlying cause of hydrometrocolpos. We report an unusual case of neonatal hydrometrocolpos in which it was extremely difficult to differentiate urogenital sinus from imperforate hymen or vaginal atresia. The patient underwent magnetic resonance imaging (MRI) which clearly showed the imperforate hymen and was helpful in planning management of the case. Hence, there is the definitive role of MRI in the differential diagnosis of hydrometrocolpos and is equally helpful in making surgical decisions.
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