Imperforate Hymen

EPIDEMIOLOGY Approximately 1:1000 until 1:10.000 PATHOPHYSIOLOGY Menarche menstrual blood is produced each month menstrual blood cannot flow out of the body month by month, the volume of menstrual blood increases accumulated in vaginal (hematocolpos) bulging blue-black membrane accumulated menstrual blood increases hematometra (uterus) hematosalping (tuba fallopii) peritoneum

CLINICAL MANIFESTATION - Bulging blue-black membrane - Cyclic abdominal pain (2 days/month) - A pelvic mass - Primary amenorrhea - Normal secondary sex characters - Continuous pain (peritoneum) DIAGNOSIS - at the time of menarche - inspection of external genitalia hymen - rectal toucher - USGdetermine the presence and extensive bleeding

DIFFERENTIAL DIAGNOSIS - Pregnancy - Urinary retention - Tuberculose peritoneal - Ovarian cyst - Vaginal aplasia THERAPY Hymenectomy + antibiotic fowler position 2-3 days