青春期女孩因阴道下段发育不全导致的阴道积血。
Hematocolpos due to lower vaginal agenesis in an adolescent girl.
作者信息
Imai Kazunori, Aoyama Kohei, Goto Takato, Kitaori Tamao, Iguchi Toshiyuki, Sasano Hiroshi, Hattori Tomonori, Sugiura-Ogasawara Mayumi, Saitoh Shinji
机构信息
Department of Emergency Medicine Nagoya City University Hospital Nagoya Japan.
Department of Pediatrics and Neonatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan.
出版信息
Acute Med Surg. 2023 Mar 7;10(1):e832. doi: 10.1002/ams2.832. eCollection 2023 Jan-Dec.
BACKGROUND
Hematocolpos due to imperforate hymen is an important differential diagnosis of abdominal pain in early adolescent stage. However, hematocolpos due to lower vaginal agenesis must be considered because the management differs.
CASE PRESENTATION
A healthy 11-year-old girl presented with a 2-day left lower abdominal pain history. Her breast development had begun, but she had not reached menarche. Computed tomography showed high absorptive value liquid filling the upper vaginal to uterine cavity, a pale highly absorptive fluid component suggestive of hemorrhagic ascites in the abdominal cavity on both sides of the uterus, and normal bilateral ovaries. Magnetic resonance imaging diagnosed hematocolpos due to lower vaginal agenesis. The blood clot was aspirated with a transabdominal ultrasound-guided transvaginal puncture.
CONCLUSION
History-taking, imaging tests, and appropriate collaboration with obstetrician/gynecologist with awareness of secondary sexual characteristics were crucial in this case.
背景
处女膜闭锁所致阴道积血是青春期早期腹痛的重要鉴别诊断。然而，由于治疗方法不同，必须考虑低位阴道发育不全所致阴道积血。
病例报告
一名健康的11岁女孩有2天左下腹痛病史。她的乳房已开始发育，但尚未初潮。计算机断层扫描显示高吸收值液体充满上阴道至子宫腔，子宫两侧腹腔内有苍白的高吸收性液体成分提示出血性腹水，双侧卵巢正常。磁共振成像诊断为低位阴道发育不全所致阴道积血。通过经腹超声引导经阴道穿刺抽吸血凝块。
结论
在本病例中，病史采集、影像学检查以及与了解第二性征的妇产科医生进行适当协作至关重要。
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