Acute abdominal pain caused by hematometra in an adolescent female: a case report

Abstract

BackgroundHematometra is a pathologic collection of blood in the uterus. 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. We present an unusual case of hematometra in a healthy and active adolescent female with no prior risk factors. This is a rare and important case report due to the complexity of diagnosis when a young female presents with an acute abdomen. In addition, for a patient who presents with no prior risk factors for hematometra, such as in our patient, the diagnosis and workup may become overly complicated, adding strain to patient care and health care cost. To the best of our knowledge and based on an extensive literature search, there has not been a reported case of hematometra in an adolescent female without any aforementioned risk factors.Case presentationOur patient is a healthy 18 year-old white woman with no significant prior medical or surgical history. Her only medication was depot medroxyprogesterone acetate use for contraception. She presented to a local emergency department with acute abdominal pain, accompanied by emesis and nausea. Workup with ultrasonography showed uterine distention most likely caused by hematometra, although no obvious cause was noted. She was treated with dilation and curettage; she was also advised to discontinue depot medroxyprogesterone acetate use. She was symptom free without recurrence of hematometra at 6-month follow-up.ConclusionsDue to the high prevalence of abdominal pain, this case report has a wide breadth of implications for health care providers ranging from general family practitioners to emergency room physicians and obstetricians/gynecologists. This case report provides potential future advancement in management and differential diagnosis in adolescent females presenting with acute abdominal pain. In addition, the use of depot medroxyprogesterone acetate contributing to or causing hematometra cannot be ruled out in our patient and warrants further investigation.

Amenorea Primer et Hematokolpos et Hematometra ec. Septum Vagina Transversal

“…Septum vagina transversum biasanya terdiagnosis saat pasien memasuki usia pubertas dan mengalami gejala nyeri abdomen yang timbul berulang tanpa mengalami menstruasi akibat adanya hematokolpos [10], [11]. Hematokolpos adalah terkumpulnya darah menstruasi pada vagina akibat adanya obtsruksi di vagina, sedangkan hematometra adalah akumulasi darah pada rongga uterus akibat obstruksi aliran darah menstruasi [12]. Tatalaksana yang dilakukan adalah operasi dan disarankan dilakukan sedini mungkin, dikarenakan tatalaksana pada pasien post pubertas memiliki risiko tinggi mengalami stenosis vagina [13], [14].…”

Self-reported health related quality of life in children and adolescents with an eating disorder

“…The past two decades research on health-related quality of life (HRQoL) in patients with an eating disorder has increased [ 4 – 8 ]. HRQoL is a subjective evaluation of the overall health of an individual, as well as the health of underlying subdimensions of physical, psychological and social functioning [ 9 ].…”