Russell Victoria Rose, Ibrahim Mohamed, Phillips Georgina, Setchell Tom, Purkayastha Sanjay
Department of General Surgery, Imperial College NHS London, London, UK
Department of General Surgery, Imperial College NHS London, London, UK.
BMJ Case Rep. 2021 Mar 9;14(3):e238547. doi: 10.1136/bcr-2020-238547.
Imperforate hymen is a rare congenital malformation of the female genital tract. The condition poses several diagnostic challenges owing to its low incidence and often atypical presentation. Classical symptoms include amenorrhoea and cyclical abdominal pain. Delayed diagnosis leads to potentially irreversible and lifechanging sequelae including infertility, endometriosis and renal failure. A premenarchal 13-year-old girl with a background of chronic constipation presented with symptoms mimicking acute appendicitis. The underlying cause was imperforate hymen and retrograde menstruation. The diagnosis was made during diagnostic laparoscopy. As with this patient, pre-existing symptoms are often troublesome long before the true diagnosis is made. This case report highlights the importance of recognising imperforate hymen as a potential cause of acute abdominal pain in premenarchal adolescent girls. The clinical picture may present as right or left iliac fossa pain. Early identification reduces the risk of adverse complications and avoids unnecessary and potentially harmful interventions.
处女膜闭锁是一种罕见的女性生殖道先天性畸形。由于其发病率低且临床表现往往不典型，这种情况带来了几个诊断挑战。典型症状包括闭经和周期性腹痛。延迟诊断会导致潜在的不可逆转且改变生活的后遗症，包括不孕、子宫内膜异位症和肾衰竭。一名13岁青春期前女孩，有慢性便秘病史，出现类似急性阑尾炎的症状。根本原因是处女膜闭锁和逆行性月经。诊断是在诊断性腹腔镜检查期间做出的。与此患者一样，在真正确诊之前，先前存在的症状往往会困扰很长时间。本病例报告强调了认识到处女膜闭锁是青春期前少女急性腹痛潜在原因的重要性。临床表现可能表现为右或左髂窝疼痛。早期识别可降低不良并发症的风险，并避免不必要的和潜在有害的干预措施。
