title: Experience with neonatal hydrometrocolpos in the Niger Delta area of Nigeria: Upsurge or increased recognition?
abstract: BACKGROUND
  Hydrometrocolpos (HMC) is a clinical condition in which there is a cystic distension of the vagina (hydrocolpos), uterus and sometimes, fallopian tubes (hydrosalpinx) with fluid. This study described our experience with cases of HMC seen in our practice, and highlighted the flare in our practice.
  
  
  METHODS
  A retrospective study of cases of HMC managed at the University of Port Harcourt Teaching Hospital between September 2010 and August 2012.
  
  
  RESULTS
  There were seven cases; their ages ranged from 2 to 27 days (median 13 days). All the patients had abdominal distension but abdominal mass was obvious only in four. Other features varied depending on the presence of sepsis or other associated anomalies. The diagnosis of HMC was missed in all cases by the referring clinicians. One patient was referred with the diagnosis of tracheoesophageal fistula and esophageal atresia, 2 with bladder outlet obstruction, 1 with intestinal obstruction, 2 with anorectal malformation, and 1 with neonatal sepsis. Ultrasound identified bulky uterus in two cases and upper urinary tract dilatation in 3 patients. Six patients had laparotomy, 1 had hymenotomy only. Postoperative complications were basically wound sepsis and rectovaginal fistula resulted.
  
  
  CONCLUSIONS
  Diagnosis of HMC should be considered as a differential in newborn girls presenting with lower abdominal mass. Attention to clinical detail is necessary to avoid a misdiagnosis.
authors.affiliation: Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
authors.forename: Philemon Ekemenye
authors.initials: PE
authors.lastname: Okoro
authors.affiliation: Department of Pathology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
authors.forename: C
authors.initials: C
authors.lastname: Obiorah
authors.affiliation: Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
authors.forename: C E
authors.initials: CE
authors.lastname: Enyindah
mesh_terms: D019468:Disease Management; D005260:Female; D006801:Humans; D052202:Hydrocolpos / Q000175:diagnosis* / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D009549:Nigeria / Q000453:epidemiology; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D014463:Ultrasonography; D014621:Vagina / Q000002:abnormalities* / Q000000981:diagnostic imaging