Mar 22, 2016 imperforate hymen is at the extreme of a spectrum of variations in hymenal configuration. It may develop after birth, abortion, intrauterine interventions. The syndrome known as imperforate hymen with hematocolpos has been recognized for centuries and yet is seldom diagnosed by the physician who first sees the patient. In older women, the obstruction is usually acquired.
Aching in pelvis and low back especially after standing for awhile. This means that in all cases where the icd9 code 621. I had the procedure scheduled and had all the preop blood work done and the endometrial biopsy first. Variations in the embryologic development of the hymen are common and result in fenestrations, septa, bands, microperforations, anterior displacement, and differences in. A rare case of hematometra and hematotrachelos springerlink.
The medical definition of hematocolpos is an accumulation of blood within the vagina. Hematometra definition at, a free online dictionary with pronunciation, synonyms and translation. It is sometimes seen in robinow syndrome, uterus didelphys, or. If cyclic or chronic lower pelvic pain occurs after surgery in menstruating women or among women taking hormone replacement therapy, scarring or narrowing of the endometrial cavity may be the cause. Excision of the imperforate hymen or transverse septum and excision of the blind uterine. Patients may notice a hematometra in the form of abnormal uterine bleeding or spotting.
Obstruction within the distal vagina is usually responsible for the development of a hematocolpos. Publications home of jama and the specialty journals of the. The uterus didelphys is undoubtedly one of the rarest malformations met by the. Hematometra presenting as an acute abdomen in a yearold. Hematometra typically presents as cyclic, cramping pain in the midline of the pelvis or lower abdomen. A large hematometra and hematocolpos were detected by transabdominal ultrasound. Pdf hematometra formation a rare complication of cesarean. Giant hematocolpos and hematometrain a pubertal girl.
However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Recurrent hematometra and hematocolpos due to cervical. It is a rare condition that is most commonly associated with congenital anomalies or prior surgical procedures causing an obstruction of the genitourinary outflow tract. Mr of the female pelvis diger mulleryen sistem anomalileri. Imperforate hymen is a rare malformation of the vagina and a possible reason of hematocolpos and hematometra in puberty. High estrogen can be caused by excessive carbohydrate intake via competetive inhibition of glucoronidase enzyme therefore a low carb diet is beneficial to reduce estrogen and help shrink fibroids. She was managed by abdominal hysterectomy and right salpingooophorectomy that included the ovarian cystadenoma. Hematocolpos definition of hematocolpos by medical dictionary. A case of massive hematometra with a bicornuate uterus in a 14yearold mentally handicapped girl complicated by vaginal agenesis and absent cervix is presented. Suspected hematometra possible by comparing history with complaints of sudden cessation of blood discharge after intrauterine intervention, a feeling of heaviness and cramping in the a. Feb 18, 2011 hematometra is an accumulation of blood within the uterus.
The ablation is promoted as being a simple procedure that can be done in one day and then all your problems are cured. It is often associated with absence of portion or all of the vagina. Resectoscopic treatment of uterus didelphys with unilateral. The details of the patients condition were discussed with the patient and her parents, including the complications of outflow obstruction to the right vagina which can lead to hematocolpos, hematometra, hematosalpinx, and later may cause a retrograde bleeding, chronic pelvic pain. Hematometra and hematocolpos, secondary to cervical. She did not have any significant medical and surgical history, and her neurological examinations were. Hematometra presenting as an acute abdomen in a year. We report a case of hematometra and hematocolpos, secondary to cervical canal occlusion treated with ultrasound guided placement. If there is a backup of blood or fluid in the vagina, this may extend into the uterine cavity and result in an associated hematometra. Hematometra causas, sintomas, diagnostico e tratamento. It is characterized by the triad of uterus didelphys, obstructed hemivagina, and. It is usually due to obstruction at the level of cervix or uterus. Obstructing vaginal malformations impede the outflow of menstrual blood flow and may cause hematocolpos, hematometra and hematosalpinx, thus increasing.
Massive hematometra due to congenital cervicovaginal agenesis. A haematometrium refers to a uterus filled with blood. The cervix is absent, and the lower uterine segment narrows to terminate in the peritoneal sleeve at a point above the normal communication with the vaginal apex. Hematocolpos definition of hematocolpos by the free. Acquired cervical stenosis can develop due to surgical procedures performed. Hymenal atresia may present at birth as hydrocolpos, mucocolpos or hydrometrocolpos, or at puberty when hematocolpos develops after menarche. Sailer animperforate hymen isthemostfrequent female genitalanomaly. Casea 14yearold girl presented with history of cyclic. The aim of this study is to report two cases with this condition and also to. Patients may also report urinary frequency and urinary retention. Most underlying diseases for abdominal pain in children are not dangerous.
The most common cause of hematocolpos is an imperforate hymen, which is associated with primary amenorrhea. Acute urinary retention is a very rare presentation of hematocolpos with less than 10 reported cases in literature. Hematometra and hematocolpos, secondary to cervical canal. Acute abdominal pain caused by hematometra in an adolescent. Imperforate hymen presenting with massive hematometra and hematocolpos. Hematocolpos is a medical condition in which the vagina is pooled with menstrual blood due to multiple factors leading to the blockage of menstrual blood flow.
This is a rare and important case report due to the. Hematometra is an infrequent late complication of operative hysteroscopy. Hematometra exact match this is the official exact match mapping between icd9 and icd10, as provided by the general equivalency mapping crosswalk. Hematocolpos medical definition merriamwebster medical.
Dec 20, 2016 hematometra is a pathologic collection of blood in the uterus. Follow up usg showed adequate drainage of hematocolpos and hematometra in these patients. You may also have low iodine, thyroid problems, low. This may lead to hematocolpos, hematometra, and hematosalpinx. You may not embed one of our images on your web page without a link back to our site.
Pdf hematometra and hematocolpos, secondary to cervical. Hematometra causes, symptoms, diagnosis and treatment. If you would like a large, unwatermarked image for your web page or. When there is concurrent uterine distention, the term hematometrocolpos is used. Ultrasound control showed a clear reduction of both the hematometra and the hematocolpos. Transvaginal ultrasonography of a hematometra after childbirth, seen as a hypoechoic darker area within the uterine cavity. There can be a number of potential causes for this condition and treatment is dependent on finding the source of the blood. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Considering cervical defect as acquired disease, you can code this as 622. A gynecologist is usually involved in diagnosis and treatment of this condition. Hematometra ginecologia esta patologia e diagnosticada relativamente rara. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license.
The details of the patients condition were discussed with the patient and her parents, including the complications of outflow obstruction to the right vagina which can lead to hematocolpos, hematometra, hematosalpinx, and later may cause a retrograde bleeding, chronic pelvic pain, endometriosis, and infertility. Top 41 on uterine hematometra treatment options healthtap. Recurrent hematometra and hematocolpos due to cervical agenesis. We report a case of recurrent hematometra and hematocolpos due to. Hematometra article about hematometra by the free dictionary. This treatment was considered appropriate for this patient. We present an unusual case of hematometra in a healthy and active adolescent female with no prior risk factors. She reported progressively increasing lower abdominal distension, with pain as well as discomfort over the prior two months, which was cyclically associated. We report a case of recurrent hematometra and hematocolpos due to cervical agenesis. Publications home of jama and the specialty journals of. Primary amenorrhea also is present when hematocolpos is caused by a complete transverse vaginal septum, vaginal agenesis, or vaginal atresia. Hematometra is a clinical term describing an accumulation of blood in the uterus. Apr, 2020 patients may notice a hematometra in the form of abnormal uterine bleeding or spotting, as well as a feeling of fullness and tenderness in the lower abdomen. Hematocolpos hematometra pdf imperforate hymen presenting with massive hematometra and hematocolpos.
The medical definition of hematocolpos is an accumulation of blood within. The code is valid for the year 2020 for the submission of hipaacovered transactions. Imperforate hymen, hematocolpos, fibrous hymen hymenal. Hematometra develops when the uterus becomes distended with blood secondary to obstruction or atresia of the lower reproductive tractthe uterus, cervix or vaginawhich would otherwise provide an outflow for menstrual blood. Retained secretions andmenstrual blood maydistend thevagina anduterus toproduce hematocolpos and hematometra resulting inanabdominal mass. A second separate uterus not shown on these images was also present. Hematometra problems with blood evacuation of the uterus, leading to its accumulation in the body.
May 23, 2019 amaryl lids to download pdf you need some things, like my website and the name of the file. Hematometra pode estar associado a ambos os patologia orgao anomalias congenitas e doencas adquiridas do utero e vagina, e razoes funcionais hemostasia inadequada e ma contracao do miometrio. Hematocolpos definition of hematocolpos by the free dictionary. Hematometra and hematotrachelos are a rare condition, which means retention of blood in uterine cavity and cervix, respectively. At puberty, indeed, the functional endometrium periodically bleeds, but because of these malformations, it may result in the obstruction of the normal menstrual. On the axial t2weighted image, the fluid collections in the vagina posterior to the bladder have varied signal, indicating subacute and more recent hemorrhage. A 17yearold nulligravida female presented to a regional emergency department for evaluation of leftlowerquadrant bulging and pain. Massive hematometra due to congenital cervicovaginal. Imperforate hymen causing hematocolpos and acute urinary. Mr imaging evaluation of obstructing vaginal malformations with. Imperforate hymen causing hematocolpos and acute urinary retention in a 14yearold adolescent we report the case of a 14yearold girl who visited the emergency room because of suprapubic discomfort and sudden acute urinary retention. Hematometra is a pathologic collection of blood in the uterus. Variations in the embryologic development of the hymen are common and result in fenestrations, septa, bands, microperforations, anterior displacement, and differences in rigidity andor elasticity of the hymenal tissue. A related disorder is hematometra, where the uterus fills with menstrual blood.
Evaluation of anterior cervical defect with a hysteroscope would be considered as diagnostic hysteroscopy and would get bundled with 58558. Premenopausal women with hematometra often experience abnormal vaginal bleeding, including dysmenorrhea pain during menstruation or amenorrhea lack of menstruation, while. The cervix is located to the left in the image, and the fundus is located to the right. Premenopausal women with hematometra often experience abnormal vaginal bleeding, including dysmenorrhea pain during menstruation or amenorrhea lack of menstruation, while postmenopausal women are more. Hematocolpos definition of hematocolpos by medical. Download the pdf to view the article, as well as its associated figures and tables. Hematometra is a condition involving collection or retention of blood or blood clots inside the uterus pic. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients. Hematometra definition of hematometra by medical dictionary.
One potential cause of hematometra is hematosalpinx, where bleeding occurs in the fallopian tube. It is often caused by the combination of menstruation with an imperforate hymen. Approximately 1% to 2% of women who undergo operative hysteroscopy. On the axial t1weighted image, two hyperintense structures, which represent a double vagina, are seen posterior to the bladder. Hydrometrocolpos, or hematocolpos, and hematometra can occur in patients with female genital tract malformation obstruction, presenting during two different stages in life because of the functional features of the endometrium, as in newborninfanthoodchildhood or at puberty. Imperforate hymen is at the extreme of a spectrum of variations in hymenal configuration. Drainage of hematometrium obgyn coding ask an expert.
Gomez arzapalo e, perez mendizabal a, herrera avalos i, et al. Hematocolpos is a term given to a bloodfilled dilated vagina due to menstrual blood in the setting of an anatomical obstruction, usually an imperforate hymen. Hematometra is an uncommon disorder that can be caused by congenital or acquired structural obstruction of the cervical canal. External genital inspection showed an intact hymen and menstrual discharge. Cpt 58558 correctly captures both drainage of hematometrium and multiple polypectomy procedures. A rare case of massive hematometra with a tuboovarian. Suspected hematometra possible by comparing history with complaints of sudden cessation of blood discharge after intrauterine intervention, a feeling of heaviness and cramping in the abdomen. Transabdominal ultrasound with a lowfilled bladder detected an 8cm. My dr only did ablation sunder general it was at the last appointment before the procedure that he went over the risks. More than 300 years ago ambroise pare described a case in which, because of amenorrhea, pain and abdominal swelling, the condition was diagnosed as pregnancy.
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