title: Hematometra presenting as an acute abdomen in a 13-year-old postmenarchal girl: a case report.
abstract: BACKGROUND
  Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where the anomaly could not be identified using a laparoscopy in an adolescent girl with acute abdomen.
  
  
  METHODS
  A 13-year old postmenarchal caucasian female presented with an acute abdomen. Emergency sonography could not exclude ovarian torsion. Accurate diagnosis and treatment were achieved only after an initial laparoscopy followed by a laparotomy and after a magnetic resonance imaging scan a further laparotomy. The underlying disease was hematometra of the right uterine horn in a uterus didelphys in conjunction with an imperforate right cervix.
  
  
  CONCLUSIONS
  This report demonstrates that the usual approach for patients with acute abdominal pain may not be sufficient in emergency situations.
authors.affiliation: Department of Pediatric Surgery, Inselspital, University of Berne, Berne, Switzerland. Ulf.Kessler@insel.ch.
authors.forename: Peter
authors.initials: P
authors.lastname: Klimek
authors.forename: Miriam
authors.initials: M
authors.lastname: Klimek
authors.forename: Ulf
authors.initials: U
authors.lastname: Kessler
authors.forename: Valerie
authors.initials: V
authors.lastname: Oesch
authors.forename: Rainer
authors.initials: R
authors.lastname: Wolf
authors.forename: Enno
authors.initials: E
authors.lastname: Stranzinger
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
authors.forename: Zacharias
authors.initials: Z
authors.lastname: Zachariou