Hematometra in Postmenarchal Adolescent Girls: A Report of Two Cases

Dadhwal, Vatsla; Mittal, Suneeta; Kumar, Sunesh; Barua, Abhijeet

doi:10.1159/000010284

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…Because of the absence of an outlet for menstrual flow, menstrual blood accumulates in the vagina (hematocolpos) and uterus (hematometra) with the onset of menstruation (2). The most common symptoms associated with the presence of an hematometra are lower abdominal pain radiating to the lower back, discomfort, and sense of fullness in the pelvis.…”

Section: Discussionmentioning

confidence: 99%

Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner’s syndrome

Sardo

Carlo

Salerno

et al. 2007

Fertility and Sterility

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Section: Discussionmentioning

confidence: 99%

Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner’s syndrome

Sardo

Carlo

Salerno

et al. 2007

Fertility and Sterility

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“…Unfortunately, the long‐term sequelae of missed diagnosis extend far beyond the acute setting and potentially can affect the integrity of the reproductive organs. These include potential endometriosis from retrograde menstruation (theoretically) with an incidence of 31% in one series (12), and there are figures ranging between 23 (12) and 74% (13). The incidence of spontaneous abortion has been quoted as being as high as 53%, 50% increase in breech deliveries, and inability of the cervix to dilate at the time of delivery necessitating caesarean section in 25% of reported cases (3,6).…”

Section: Discussionmentioning

confidence: 99%

An unusual cause of lower back pain: uterus didelphys and unilateral cervical atresia

Knight

Birknshaw

2005

International Journal of Clinical Practice

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Backache among adolescents and young women is an unusual presenting feature to the Accident and Emergency Department as well as orthopaedic clinics. Here, we present a challenging case of a mullerian duct abnormality, which collectively has an incidence of 0.0001% of the population, and how its consideration and investigation will ensure optimum management in both acute and long term.A 14-year-old, healthy, post-menarchal, nulliparous woman presented to the Accident and Emergency (A&E) Department complaining of persistent backache of 3 months duration which radiated down her right buttock and was not relieved by simple analgesia. On her first presentation to the A&E Department, she was noted to have no bruising or swelling in the area, but her S4 region was tender. No other investigations were performed. She was reviewed by another consultant who prescribed analgesia and physiotherapy.One month later, after having been referred to an orthopaedic consultant by her general practitioner, she again presented to the A&E Department with worsening symptoms, keeping her awake at night and forcing her to stay away from school. There was no history of injury or new source of stress to the spine. On orthopaedic examination, she was noted to have no scoliosis, lordosis or kyphosis of the spine. There were no congenital abnormalities or muscle wasting noted, although there seemed to be a questionable 1.5 cm real leg length discrepancy as was borne out by the uneven wear of her shoes. She was noted to have a normal range of movement in her spine and at flexion was able to touch the floor flathanded. Straight leg when raised to 30˚was painful, especially on the right, but there were no neurological or vascular abnormalities. Radiographs of the spine were normal.In the orthopaedic Outpatient Department, she was found to demonstrate the same features as before although the pain had improved significantly. A full blood count (FBC), erythrocyte sedimentation rate (ESR), C-reactive protein test (CRP) were performed. All were normal. A magnetic resonance imaging (MRI) scan was arranged. The patient began to seek chiropractic treatment by this time.Three months after her first A&E presentation, she again presented to the department with the same pain but the severity was increasing. A thorough re-evaluation of the history revealed that the pain was related exactly to the onset of her periods. The pain would last for 3 weeks, subside for 1 week and then recur exactly on the first day of menstruation. She did not complain of any menstrual anomalies such as menorrhagia or metorrhagia. She was not sexually active, had no vaginal discharge, the urine was free of any pathology and the pregnancy test was negative. Her abdomen was noted to be soft and non-tender, and no masses or anomalies were identified. The Laseque test was positive and radiated around her buttock, but no neuropathology was noted.The gynaecological registrar was consulted due to the ensuing history, and it was decided to try her on oral contraceptive medication to exclude ...

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“…In 80% -90% of cases, there is no communicating channel between the two uterine cavities [1]. There are many cases reported with non-communicating rudimentary horn and the functioning endometrium associated with various complications such as dysmenorrhoea, adenomyosis, ectopic pregnancy and haematometra [2,3].…”

Section: Introductionmentioning

confidence: 99%

Non-Communicating inactive rudimentary horn of the uterus presenting with dysmenorrhoea—a case report of successful laparoscopic excision

Dwivedi¹,

Perera²,

Eedarapalli³

2011

OJOG

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Uterine developmental abnormalities can cause both obstetric and gynaecological complications. Non-functioning rudimentary uterine horn is a rare cause of dysmenorrhoea which usually starts after menarche. Cases with lateral/inferior arrangement of blood supply to the functioning rudimentary horn and lapascopic removal have been described in literature. Ours is a unique case of non-functioning rudimentary horn with an unusual medial arrangement of vasculature successfully treated by laparoscopic excision. We also present a brief review of the literature. The patient presented with irretractable dysmenorrhoea despite hormonal manipulation and analgesics. Following the diagnosis using laparoscopy and hysteroscopy and MRI, the left sided non-communicating rudimentary horn with inactive endometrium was removed laparoscopically. Her symptoms were resolved and this was followed by successful pregnancies. Diagnosis of rudimentary horn with inactive endometrium is difficult. Ultrasound is unreliable. MRI, 3D CT scan and 3D ultrasound are gaining popularity. Accurate, prior identification of the type using laparoscopy and hysteroscopy if necessary is essential. This helps in surgical planning. The laparoscopic approach is increasingly being used to resect these horns due to its safety and merits.

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Hematometra in Postmenarchal Adolescent Girls: A Report of Two Cases

Abstract: We report two cases of unicornuate uterus with functioning rudimentary horn to highlight that Mullerian duct anomalies should be considered in the differential diagnosis of severe dysmenorrhoea even in normally menstruating girls.

Cited by 8 publications

References 6 publications

Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner’s syndrome

Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner’s syndrome

An unusual cause of lower back pain: uterus didelphys and unilateral cervical atresia

Non-Communicating inactive rudimentary horn of the uterus presenting with dysmenorrhoea—a case report of successful laparoscopic excision

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