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Adolescent Haematocolpos: Seek and You Shall Find

Received: 10 June 2021     Accepted: 28 June 2021     Published: 2 July 2021
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Abstract

An adolescent girl presented to the emergency department with a history of abdominal pain, dribbling, and inability to pass urine for the last 24 hours. The initial observations and examination of respiratory, cardiovascular, ears, nose, and throat (ENT), central nervous system (CNS) and musculoskeletal systems were normal. No onset of menses reported by the patient. She was found to have a palpable distended bladder on abdominal examination. A catheter was inserted by the nurse, who reported no abnormalities. The physician did not perform a FAST scan nor conduct a genital examination. The patient was referred to the paediatrics department and the following day an ultrasound examination led to a diagnosis of haematometrocolpos. The patient was the referred to the obstetric and gynaecological department. Corrective surgery was conducted the following day and she was discharged on the fourth day. While the diagnosis and treatment were correct, had a FAST scan and/or genital examination been part of the initial work-up, diagnosis would have been made in the emergency department and an appropriate referral made directly to obstetric and gynaecological team. Rapid diagnosis and treatment would have benefitted the patient, reduced the risks of complications, and cut the length of stay in the hospital by as much as two days.

Published in Clinical Medicine Research (Volume 10, Issue 4)
DOI 10.11648/j.cmr.20211004.11
Page(s) 112-115
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Haematocolpos, Urinary Retention, FAST, Ultrasound, PoCUS

References
[1] Shekelle P, Pronovost P, Wachter R, Taylor S, Dy S, Foy R, et al. Advancing the science of patient safety. Ann Intern Med. 2011; 154: 693–96.
[2] Newman-Toker D, Wang Z, Zhu Y, Nassery N, Saber Tehrani A, Schaffer A, et al. Rate of diagnostic errors and serious misdiagnosis-related harms for major vascular events, infections, and cancers: toward a national incidence estimate using the “Big Three”. Diagnosis. 2021; 8 (1): 67-84.
[3] Huang Q, Thind A, Dreyer, J, Zaric G. The impact of delays to admission from the emergency department on inpatient outcomes. BMC Emerg Med (2010); 10, 16. doi: 10.1186/1471-227X-10-16.
[4] Caesar U, Karlsson J, Hansson E. Incidence and root causes of delays in emergency orthopaedic procedures: a single-centre experience of 36,017 consecutive cases over seven years. Patient Saf Surg. 2018; 12: 2. doi: 10.1186/s13037-018-0149-1.
[5] Hussain F, Cooper, A, Carson-Stevens A, Donaldson L, Hibbert P, Hughes T, et al. Diagnostic error in the emergency department: learning from national patient safety incident report analysis. BMC Emerg Med 2019: 19, 77. doi: 10.1186/s12873-019-0289-3.
[6] Bari A, Khan R, Rathore A. Medical errors; causes, consequences, emotional response and resulting behavioral change. Pak J Med Sci. 2016; 32 (3): 523–28.
[7] Verghese A, Charlton B, Jerome P. Kassirer J, Ramsey M, Ioannidis J. Inadequacies of physical examination as a cause of medical errors and adverse events: a collection of vignettes. AM J Med. 2015; 128 (12): 1322-24.
[8] Asgari S, Mansour Ghanaie, M., Simforoosh, N., Kajbafzadeh, A., Zare', A., Acute urinary retention in children. Urol J. 2005; 2 (1): 23-27.
[9] Effa E, Ojo, O., Ihesie, A., Meremikwu, M., Deinfibulation for treating urologic complications of type III female genital mutilation: A systematic review. Int J Gynecol Obstet 2017; 136: 30-33.
[10] Gatti J,Perez-Brayfield, M., Kirsh, A., Smith, E., Massad, H., Acute urinary retention in children. J Urol 2001; 2013: 918-21.
[11] Posner J, Spandorfer, P., Early detection of imperforate hymen prevents morbidity from delays in diagnosis. Pediatrics 2005; 115 (4): 1008-12.
[12] Lardenije C, a cause of abdominal pain in female adolescents. Case Reports, 2009 (may26 1): bcr0820080722-bcr0820080722.
[13] Cormac C, Wald, A., Coombs, P., Kallos, L. and Blecher, G., Time to establish pillars in point-of-care ultrasound. Australasian Journal of Ultrasound in Medicine 2019; 22 (1): 12-14.
[14] Kotter H, Weingrow, D., Canders, C., Hematometrocolpos in a pubescent girl with abdominal pain. Clin Pract Cases Emerg Med 2017; 1 (3): 218–20.
[15] Horner G, Genitourinary assessment: an integral part of a complete physical examination. J Pediatr Health Car 2007; 21 (3): 162-70.
Cite This Article
  • APA Style

    Volha Pankevich. (2021). Adolescent Haematocolpos: Seek and You Shall Find. Clinical Medicine Research, 10(4), 112-115. https://doi.org/10.11648/j.cmr.20211004.11

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    ACS Style

    Volha Pankevich. Adolescent Haematocolpos: Seek and You Shall Find. Clin. Med. Res. 2021, 10(4), 112-115. doi: 10.11648/j.cmr.20211004.11

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    AMA Style

    Volha Pankevich. Adolescent Haematocolpos: Seek and You Shall Find. Clin Med Res. 2021;10(4):112-115. doi: 10.11648/j.cmr.20211004.11

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  • @article{10.11648/j.cmr.20211004.11,
      author = {Volha Pankevich},
      title = {Adolescent Haematocolpos: Seek and You Shall Find},
      journal = {Clinical Medicine Research},
      volume = {10},
      number = {4},
      pages = {112-115},
      doi = {10.11648/j.cmr.20211004.11},
      url = {https://doi.org/10.11648/j.cmr.20211004.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20211004.11},
      abstract = {An adolescent girl presented to the emergency department with a history of abdominal pain, dribbling, and inability to pass urine for the last 24 hours. The initial observations and examination of respiratory, cardiovascular, ears, nose, and throat (ENT), central nervous system (CNS) and musculoskeletal systems were normal. No onset of menses reported by the patient. She was found to have a palpable distended bladder on abdominal examination. A catheter was inserted by the nurse, who reported no abnormalities. The physician did not perform a FAST scan nor conduct a genital examination. The patient was referred to the paediatrics department and the following day an ultrasound examination led to a diagnosis of haematometrocolpos. The patient was the referred to the obstetric and gynaecological department. Corrective surgery was conducted the following day and she was discharged on the fourth day. While the diagnosis and treatment were correct, had a FAST scan and/or genital examination been part of the initial work-up, diagnosis would have been made in the emergency department and an appropriate referral made directly to obstetric and gynaecological team. Rapid diagnosis and treatment would have benefitted the patient, reduced the risks of complications, and cut the length of stay in the hospital by as much as two days.},
     year = {2021}
    }
    

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    AU  - Volha Pankevich
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    JO  - Clinical Medicine Research
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    PB  - Science Publishing Group
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    AB  - An adolescent girl presented to the emergency department with a history of abdominal pain, dribbling, and inability to pass urine for the last 24 hours. The initial observations and examination of respiratory, cardiovascular, ears, nose, and throat (ENT), central nervous system (CNS) and musculoskeletal systems were normal. No onset of menses reported by the patient. She was found to have a palpable distended bladder on abdominal examination. A catheter was inserted by the nurse, who reported no abnormalities. The physician did not perform a FAST scan nor conduct a genital examination. The patient was referred to the paediatrics department and the following day an ultrasound examination led to a diagnosis of haematometrocolpos. The patient was the referred to the obstetric and gynaecological department. Corrective surgery was conducted the following day and she was discharged on the fourth day. While the diagnosis and treatment were correct, had a FAST scan and/or genital examination been part of the initial work-up, diagnosis would have been made in the emergency department and an appropriate referral made directly to obstetric and gynaecological team. Rapid diagnosis and treatment would have benefitted the patient, reduced the risks of complications, and cut the length of stay in the hospital by as much as two days.
    VL  - 10
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Author Information
  • Emergency Department, Sunshine Coast University Hospital, Birtinya Queensland, Australia

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