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Gynaecology & Obstetrics Primary Amenorrhea 6a1cb9d6

A 13-year-old young girl presents in the casualty with actue pain in the lower abdomen. She has history of cyclical pain for last 6 months and she has not attained her menarche yet. On local genital examination, a tense bulge in the region of hymen was seen. The most probable diagnosis is:

A
Rockytansky Kuster Hauser syndrome
B
Testicular feminization syndrome
C
Imperforate hymen
D
Asherman's sydrome
High-Yield Explanation
Ans is 'c' i.e. imperforate hymen It is a clear cut case of hematocolposAn imperforate hymen causing hematocolpos is quite common in young girls in whom, menarche has not yet set in .As the vagina gets progressively and increasingly distended with the menstrual blood, pressure symptoms occur, which are:Patients presents with colicky abdominal pain which is often cyclic.There is difficulty in micturition which finally ends up with urinary retention.On examination a hypogastric or suprapubic bulge is obvious which may cause discomfort on palpation.On separation of labia a bluish bulging labia is recognized.T/T-Surgical excision of the hymen and drainage of hematocolpos.If the hematocolpos is left untreated it may lead to hematometra and hematosalpinx.

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