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Case Reports in Obstetrics and Gynecology
Volume 2014 (2014), Article ID 406219, 4 pages
http://dx.doi.org/10.1155/2014/406219
Case Report

Concomitant Imperforate Hymen and Transverse Vaginal Septum Complicated with Pyocolpos and Abdominovaginal Fistula

1Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Ankara, Turkey
2Department of Radiology, Diskapi Children’s Hospital and Hematology Oncology Education and Research Hospital, Ankara, Turkey

Received 26 September 2013; Accepted 31 December 2013; Published 10 February 2014

Academic Editors: K. Dafopoulos and I. Kowalcek

Copyright © 2014 Berna Dilbaz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 13-year-old patient with a complaint of worsening lower abdominal pain during the past 4 months was admitted to the emergency department. An abdominopelvic ultrasound scan revealed a distended uterocervical cavity suggestive of hematometrocolpos. Imperforate hymen was observed on examination of the external genitalia. MRI scan revealed an air-fluid level representing pyometrocolpos within a distended vagina. Posterior vaginal extraperitoneal leakage as the sign of a fistula between the vagina and the rectovaginal space was detected. Although laparoscopic approach was planned, malodorous pus expelled after the insertion of the Veress needle, it was decided to proceed to laparotomy. Pus with peritoneal microabscess formations was observed at laparotomy. The imperforate hymen and TVS were excised vaginally. A more complex anomaly should be suspected in cases with hematometra and concomitant imperforated hymen without any bulging and thorough evaluation using radiological imaging techniques should be performed before surgical approach.