Imperforate hymen

It results from failure of canalization of the lower third of the vaginal plate during the development 

A neonate can have mucocolpos (mucus accumulation in the vagina causing bulging of the hymen) or this condition may not be diagnosed in childhood unless a female presents at 13-14 years of age when she undergoes menarche. Then menstruating blood accumulates in the vagina but cannot come outside (primary amenorrhea) because the hymen is intact, thus it causes bluish bulging outside (this is called hematocolpos). 






She can experience cyclical abdominal pain, weight loss, and loss of appetite. She can experience constipation due to compression symptoms. Since Hymen is not perforated, she has retrograde menstruation, which means blood flows in the fallopian tube which then spills into the peritoneal cavity causing intraabdominal adhesions.

on examination, we can find tender suprapubic mass due to blood accumulation in the uterus causing uterine enlargement.

The treatment is hymenectomy.

sometimes this can be confused with sarcoma botryoides which are present in infants and childhood. It is a grape-like cluster of a mass protruding in the vagina (non-friable nodules)







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