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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2024, Number 1

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Bol Clin Hosp Infant Edo Son 2024; 41 (1)

Imperforate hymen: Diagnosis and treatment preserving hymen integrity. A case presentation

López CG, López DAV, Bravo TM, López DPS, Rodríguez GJ, Pacheco BCF, Reyes GU, Reyes HMU, Reyes HK, Martínez HY, Martínez HLA, Rosas PNE, Escalera AP, Hernández GMA

Language: Spanish
References: 27
Page: 54-58
PDF size: 193.26 Kb.


ABSTRACT

Imperforate hymen is the most common congenital malformation of the female genital tract. It is a rare congenital anomaly with a prevalence of 0.05-0. A 12-year-old female patient began experiencing symptoms 8 days prior after falling from her own height while playing; 3 days later, she complained of low back pain, dysuria, and proctalgia. Physical examination revealed an abdomen without signs of peritoneal irritation, enlarged due to an abdominal mass in the hypogastrium with firm consistency. Tanner stage III. Genitals showed an imperforate hymen protruding. Laboratory findings: Hemoglobin 12.90, hematocrit 38.30, platelets 278,000, bands 0.04, activated partial thromboplastin time 28.8 sec; prothrombin time 13.5 sec; glucose 88 mg/dl, creatinine 0.70. Abdominal pelvic ultrasound revealed an anechoic collection of approximately 480 ml compressing the bladder, extending from the hypogastrium to the pelvic cavity. Surgical treatment was performed using the Capraro technique, utilizing the modified Funck-Brentano device with the aid of gauze. This allowed for hymenoplasty, providing a labial hymen while preserving hymen integrity. The diagnosis is easy to make but must be suspected. Late discovery can lead to endometriosis and infertility. In cultures and religions where hymen destruction is a social issue, surgical practice should aim to preserve virginity.


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