title: Imperforate hymen presenting as vaginal cyst in a 16-month-old child - considerations for an early diagnosis.
abstract: Imperforate hymen is a congenital anomaly of female external genitalia, which is mostly diagnosed in puberty, at the age of 9-13 years, or very rarely at a younger age. Clinical picture varies from abdominal pain and low back pain to acute urinary retention. We describe a case of a 16-month-old female infant where the imperforate hymen presented as a vaginal cyst. The cyst was first observed by the patient's mother, although the child had been examined by a paediatrician on several occasions after birth. Complete workup performed for differential diagnosis, mostly to exclude other reproductive system anomalies, led to the final diagnosis of imperforate hymen. The aim of this report is to emphasise the necessity of thorough examination of genitalia in female newborns in order to avoid possible complications associated with this diagnosis later in life, as well as other, more severe differential diagnostic anomalies.
authors.affiliation: 1Pediatric Surgeon, Department of Pediatrics Surgery, University Hospital Centre Rijeka, Rijeka, Croatia neda.glavan@ri.t-com.hr.
authors.forename: Nedeljka
authors.initials: N
authors.lastname: Glavan
authors.affiliation: Professor and Chair of the Department of Gynecology, Department of Obstetrics and Gynecology, University Hospital Centre Rijeka, Rijeka, Croatia.
authors.forename: Herman
authors.initials: H
authors.lastname: Haller
authors.affiliation: Gynecologist, Department of Obstetrics and Gynecology, University Hospital Centre Rijeka, Rijeka, Croatia.
authors.forename: Alemka
authors.initials: A
authors.lastname: Brnčić-Fischer
authors.affiliation: Gynecologist, Department of Obstetrics and Gynecology, University Hospital Centre Rijeka, Rijeka, Croatia.
authors.forename: Lana
authors.initials: L
authors.lastname: Glavan-Gačanin
authors.affiliation: Professor and Chair of the Department of Radiology, Department of Radiology, University Hospital Centre Rijeka, Rijeka, Croatia.
authors.forename: Damir
authors.initials: D
authors.lastname: Miletić
authors.affiliation: Professor and Chair of the Department of Pathology, Department of Pathology, School of Medicine, University of Rijeka, Rijeka, Croatia.
authors.forename: Nives
authors.initials: N
authors.lastname: Jonjić
mesh_terms: D000013:Congenital Abnormalities; D003560:Cysts; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D006924:Hymen / Q000002:abnormalities*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008599:Menstruation Disturbances / Q000175:diagnosis*; D014623:Vaginal Diseases; D060528:Wnt4 Protein / Q000235:genetics
chemical_list: D060528:Wnt4 Protein
keywords: Imperforate hymen; infant; vaginal cyst