title: Imperforate hymen: a cause of abdominal pain in female adolescents.
abstract: A 16-year-old girl presented with primary amenorrhea and had had cyclical abdominal pain for almost a year. At examination we observed a painful mass in the lower abdomen and normal secondary sex characteristics. Perineal examination showed a bluish bulging hymen. Transabdominal ultrasonography revealed a dense mass in the pelvis measuring about 12×11 cm. We diagnosed an imperforate hymen with haematocolpos and haematometra. The hymen was opened surgically and a large quantity of menstrual blood was drained from the vagina and uterus. Postoperative recovery was normal without any pain. The patient now menstruates regularly. An imperforate hymen occurs in 0.05% of women. It is important to be aware of this while examining a female adolescent presenting with cyclical abdominal pain and primary amenorrhea. Late discovery of an imperforate hymen may lead to pain, infections, hydronephrosis and endometriosis with subfertility as a possible consequence.
authors.affiliation: Orbis Medical Centre, Obstetrics and Gynaecology, PO Box 5500, Sittard, 6130 MB, The Netherlands.
authors.forename: Céline
authors.initials: C
authors.lastname: Lardenoije
authors.forename: Robert
authors.initials: R
authors.lastname: Aardenburg
authors.forename: Helen
authors.initials: H
authors.lastname: Mertens