II. Epidemiology

  1. Presents in teenage girls at Menarche

III. Pathophysiology

  1. An Imperforate Hymen traps menstrual blood
  2. Pain results from blood collection or retrograde menstrual flow into the Pelvis

IV. Symptoms

  1. No Menses
  2. Vague Abdominal Pain
    1. May be chronic or recurrent

V. Signs

  1. Hematocolpos
    1. Introitus with blue, bulging membrane
    2. Represents blood trapped behind Imperforate Hymen

VI. Management

  1. Operating room hymenectomy
    1. Performed by gynecology or pediatric surgery
    2. Avoid incising Hematocolpos in the emergency department

VII. References

  1. Claudius and Willner in Herbert (2019) EM:Rap 19(1): 2-4

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