Anomalies of the genital organs development with menstrual blood outflow disorders in the practice of a pediatric surgeon
DOI:
https://doi.org/10.15574/PS.2025.2(87).118123Keywords:
developmental anomalies, genitals, «acute abdomen», hematocolpos, hematometra, non-perforated hymen, OHVIRA syndrome, pediatric surgeon's tactics, girlsAbstract
Early detection of genital malformations in girls, providing the timely and qualified medical care will help to preserve their reproductive health in future. However, the rarity of pathology and diversity of the clinical picture complicate timely diagnosis of genital abnormalities in children, leading to incorrect management tactics and unjustified surgical interventions.
Aim - to present your own experience in treating girls aged 11-13 years with imperforate hymen and OHVIRA syndrome. Painful abdominal syndrome and presence of tumor-like formation in abdominal cavity were the reasons for hospitalization.
Clinical cases. An 11-year-old girl was hospitalized with abdominal pain and urinary retention. The one month interval pain had been disturbing for 6 months. An ultrasound examination revealed a tumor-like mass in the pelvic cavity with a liquid content. Diagnostic laparoscopy revealed an enlarged uterus with dilated fallopian tubes up to 5-6 weeks of pregnancy. During the gynecological examination a non-perforated hymen was diagnosed. A 13-year-old teenage girl was hospitalized with cyclical pain in the lower abdomen and right hypochondrium associated with menstruation, which first appeared since menarche. Ultrasound examination revealed a liquid-contented tumor-like mass in pelvic cavity, absence of the right kidney. Multislice computed tomography revealed an agenesis of the right kidney, two separate uteri, the right uterus communicated with a right-sided ‘blind’ hematocolpos formed by vaginal membrane. OHVIRA syndrome was diagnosed. Teenage girls with above mentioned symptoms should be examined by a paediatric gynaecologist. If agenesis or other renal malformations are detected, girls in premenarcheal period should do gynecological examination to exclude OHVIRA syndrome.
The research was carried out in accordance with the principles of the Helsinki Declaration. Informed consent was obtained from parents (or guardians) and children.
No conflict of interests was declared by the authors.
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