Hematometra is a condition involving collection or retention of blood or blood clots inside the uterus pic. Le guide des sorties et loisirs en famille partout en france pour les vacances. The cervix is absent, and the lower uterine segment narrows to terminate in the peritoneal sleeve at a point above the normal communication with the vaginal apex. The ultrasound findings are described and discussed.
Articles on hematocolpos in n eng j med, lancet, bmj. It is sometimes seen in robinow syndrome, uterus didelphys, or. Imperforate hymen causing hematocolpos and acute urinary retention in a 14yearold adolescent we report the case of a 14yearold girl who visited the emergency room because of suprapubic discomfort and sudden acute urinary retention. Vaginal examination usually reveals a paravaginal mass, and pelvic ultrasound shows hematometra and hematocolpos on the obstructed side fig. It may be, rarely, seen as a post surgical complication as in our case. Imperforate hymen occurs in approximately 1 in 1,000 females 1, and found incidentally on physical exam 43%, it is treatable and does not cause significant morbidity 2. Custom fabricated acrylic vaginal stent as an adjunct. I had the procedure scheduled and had all the preop blood work done and the endometrial biopsy first. Imperforate hymen presenting with massive hematometra and. Hematometra causas, sintomas, diagnostico e tratamento. Examination under anesthesia bundled procedure and cant be reported revealed a bulging vaginal outlet. To document the occurrence of hematocolpos causing sciatica and leg weakness in an adolescent girl.
Hematometra and hematocolpos, secondary to cervical canal. Hematometra, which developed in the first weeks after birth, is called lohiometra. May 23, 2019 hematocolpos hematometra pdf imperforate hymen presenting with massive hematometra and hematocolpos. A diagnosis of hematocolpos secondary to imperforate hymen was made and surgically confirmed. Patients with complete obstructing longitudinal vaginal septa present with cyclic periods associated with increasingly severe dysmenorrhea fig. Imperforate hymen presenting with massive hematometra and hematocolpos. My dr only did ablation sunder general it was at the last appointment before the procedure that he went over the risks. The code is valid for the year 2020 for the submission of hipaacovered transactions.
Hi melanie, i would like to ask your coding suggestion for the above procedures. Patients may also report urinary frequency and urinary retention. Hematometra definition of hematometra by medical dictionary. The syndrome known as imperforate hymen with hematocolpos has been recognized for centuries and yet is seldom diagnosed by the physician who first sees the patient. If there is a backup of blood or fluid in the vagina, this may extend into the uterine cavity and result in an associated hematometra. In the late and neglected stages, the tubes may also be distended after the fimbrial ends become. Hematometra and hematocolpos, secondary to cervical. The upper potion of the vagina was also dilated and filled with blood hematocolpos, and ended blindly owing to the presence of a vaginal atresia. Hydrometrocolpos, or hematocolpos, and hematometra can occur in patients with female genital tract malformation obstruction, presenting during two different stages in life because of the functional features of the endometrium, as in newborninfanthoodchildhood or at puberty. Hematocolpometra definition of hematocolpometra by. Pdf hematometra and hematocolpos, secondary to cervical. Feb 18, 2011 hematometra is an accumulation of blood within the uterus. This treatment was considered appropriate for this patient. Variations in the embryologic development of the hymen are common and result in fenestrations, septa, bands, microperforations, anterior displacement, and differences in rigidity andor elasticity of the hymenal tissue.
Hematometra is an uncommon disorder that can be caused by congenital or acquired structural obstruction of the cervical canal. Hematocolpos the reader wiki, reader view of wikipedia. Aching in pelvis and low back especially after standing for awhile. This may lead to hematocolpos, hematometra, and hematosalpinx. Apr, 2020 patients may notice a hematometra in the form of abnormal uterine bleeding or spotting, as well as a feeling of fullness and tenderness in the lower abdomen. Hematocolpos definition of hematocolpos by the free dictionary. Most often, this complication arises because of the uterine atony postpartum, the cause of which may become a weak labor activity, hyperextension of the uterus large fruit, manual removal of placenta, hemorrhagic shock, scars on the uterus and others. Malformations of the female generative organs hematocolpos. Hematometra ginecologia esta patologia e diagnosticada relativamente rara. She reported progressively increasing lower abdominal distension, with pain as well as discomfort over the prior two months, which was. It may also be found in elderly women with cervical stenosis. Obstruction within the distal vagina is usually responsible for the development of a hematocolpos. Hematocolpos hematometra pdf imperforate hymen presenting with massive hematometra and hematocolpos. Hematocolpos is a medical condition in which the vagina is pooled with menstrual blood due to multiple factors leading to the blockage of menstrual blood flow.
Hematocolpos medical definition, flashcards and icd10 codes. Hematometra article about hematometra by the free dictionary. The medical definition of hematocolpos is an accumulation of blood within the vagina. The cervix is located to the left in the image, and the fundus is located to the right. Sailer animperforate hymen isthemostfrequent female genitalanomaly. I have chosen 58999 for the evacuation procedures, 56700 for the hymenectomy and 58180 for the dilation and suction curettage of the uterus in a case of an 11 year old girl with a complete imperforate hymen. It is sometimes seen in robinow syndrome, uterus didelphys, or other vaginal anomalies. Evidence based medicine cochrane collaboration on hematocolpos. As it enlarges, it presses on the brain and can cause neurological symptoms, such as headaches, weakness, sensory loss, balance and coordination problems, andor hydrocephalus a. A haematometrium refers to a uterus filled with blood. On the axial t1weighted image, two hyperintense structures, which represent a double vagina, are seen posterior to the bladder. This video shows hematocolpos with hematometra or hemometra. A rare case of hematometra and hematotrachelos springerlink.
All types present with hematometra, but only the patients with distal vaginal agenesis or hypoplasia and the obstructed didelphys also have hematocolpos. Hematocolpos medical definition merriamwebster medical. Hematocolpos definition of hematocolpos by medical. Preoperative ultrasound diagnosis of hematocolpos sciencedirect. Hematometra is an infrequent late complication of operative hysteroscopy. A case of massive hematometra with a bicornuate uterus in a 14yearold mentally handicapped girl complicated by vaginal agenesis and absent cervix is presented. Hematocolpos is a term given to a bloodfilled dilated vagina due to menstrual blood in the setting of an anatomical obstruction, usually an imperforate hymen. Considering cervical defect as acquired disease, you can code this as 622. It can be caused by a series of medical problems or diseases, and the treatment consists in. Case report endometrial carcinoma presenting as hematometra mimicking a large pelvic cyst mingping wu, md,1,2 chungchieng wu, md,3 fongming chang, md, phd,4 ernest y. Hematocolpos definition of hematocolpos by medical dictionary.
A case report okafor ii, odugu bu, ugwu ia, oko ds, enyinna pk and onyekpa ij department of obstetrics and gynecology, enugu state university teaching hospital, enugu, nigeria abstract. Hemangioblastoma genetic and rare diseases information. Approximately 1% to 2% of women who undergo operative hysteroscopy. Cpt 58558 correctly captures both drainage of hematometrium and multiple polypectomy procedures. Common symptoms associated with this disorder include amenorrhea or dysmenorrhea in premenopausal women, pelvic pain or pressure, urinary. Imperforate hymen causing hematocolpos and acute urinary.
It is often caused by the combination of menstruation with an imperforate hymen. A second separate uterus not shown on these images was also present. Usually is associated with stone impacted in urethra or congenital anomalies. It is conditioned by anatomical obstruction of the exit way from menstrual bled, that can release the presentation forms described as hematocolpos, hematometra and he. Hematometra or hemometra is a medical condition where collection or retention of blood is seen in the uterus. The details of the patients condition were discussed with the patient and her parents, including the complications of outflow obstruction to the right vagina which can lead to hematocolpos, hematometra, hematosalpinx, and later may cause a retrograde bleeding, chronic pelvic pain, endometriosis, and infertility. One potential cause of hematometra is hematosalpinx, where bleeding occurs in the fallopian tube. Depending upon the amount of blood accumulated, it first distends the vagina hematocolpos. If cyclic or chronic lower pelvic pain occurs after surgery in menstruating women or among women taking hormone replacement therapy, scarring or narrowing of the endometrial cavity may be the cause. Patients with incomplete longitudinal vaginal septa may present with irregular bleeding and. Retained secretions andmenstrual blood maydistend thevagina anduterus toproduce hematocolpos and hematometra resulting inanabdominal mass.
A related disorder is hematometra, where the uterus fills with menstrual blood. Hematometra typically presents as cyclic, cramping pain in the midline of the pelvis or lower abdomen. We report in this case, 10 years old child presented with acute urinary retention. When there is concurrent uterine distention, the term hematometrocolpos is used. The uterine wall is thicker than the vaginal wall and the vagina appears more distended. Mri for the diagnosis of uterine anomalies eshre manchester. Transvaginal ultrasonography of a hematometra after childbirth, seen as a hypoechoic darker area within the uterine cavity. Hi, for the above mentioned scenario cpt 57 seems appropriate. Recurrent hematometra and hematocolpos due to cervical. Hematometra develops when the uterus becomes distended with blood secondary to obstruction or atresia of the lower reproductive tractthe uterus, cervix or vaginawhich would otherwise provide an outflow for menstrual blood. In older women, the obstruction is usually acquired. Premenopausal women with hematometra often experience abnormal vaginal bleeding, including dysmenorrhea pain during menstruation or amenorrhea lack of menstruation, while postmenopausal women are more. The ablation is promoted as being a simple procedure that can be done in one day and then all your problems are cured.
Mar 22, 2016 imperforate hymen is at the extreme of a spectrum of variations in hymenal configuration. Presented are two cases of imperforate hymen with hematocolpos seen in a pediatric emergency department ed during a sevenmonth period. Recurrent hematometra and hematocolpos due to cervical agenesis. We report a case of recurrent hematometra and hematocolpos due to. It is often associated with absence of portion or all of the vagina.
A 17yearold nulligravida female presented to a regional emergency department for evaluation of leftlowerquadrant bulging and pain. Hematocolpos definition of hematocolpos by the free. Hematocervix, una nueva variedad marcelino hernandez. The uterus is next involved and the cavity dilated hematometra. She was managed by abdominal hysterectomy and right salpingooophorectomy that included the ovarian cystadenoma. The first case presented with abdominal pain, urinary obstruction, and constipation on initial visit. It is usually due to obstruction at the level of cervix or uterus. We report a case of recurrent hematometra and hematocolpos due to cervical agenesis. Massive hematometra due to congenital cervicovaginal agenesis. Hematometra pode estar associado a ambos os patologia orgao anomalias congenitas e doencas adquiridas do utero e vagina, e razoes funcionais hemostasia inadequada e ma contracao do miometrio. A gynecologist is usually involved in diagnosis and treatment of this condition. Hematometra is usually seen in adolescent females with imperforate hymen or with a transverse vaginal septum.
A case of hematocolpos in a 17yrold girl is presented. Discussion on ultrasound the uterus and vagina are distended with fluid showing low level echoes with posterior enhancement. Return back by esc key or x button in the right bottom corner. On the axial t2weighted image, the fluid collections in the vagina posterior to the bladder have varied signal, indicating subacute and more recent hemorrhage. Gomez arzapalo e, perez mendizabal a, herrera avalos i, et al. A hemangioblastoma is a benign, highly vascular tumor that can occur in the brain, spinal cord, and retina the lightsensitive tissue that lines the back of the eye. She did not have any significant medical and surgical history, and her neurological examinations were. Subscribe to our newsletter and receive the latest news. Hematocolpos secondary to imperforate hymen article pdf available in international journal of emergency medicine 34. Based on patient age and clinical history, and the classic findings of dilated fluid filled vagina and uterus, the diagnosis was hematometrocolpos due to imperforate hymen. A case report abstract the hematometra should be suspected in a patient with amenorrhea and recurrent pain in low stomach.
Acquired cervical stenosis can develop due to surgical procedures performed on the uterus or cervix. Mr of the female pelvis diger mulleryen sistem anomalileri. Eshre pages the thessaloniki eshreesge consensusondiagnosisoffemalegenital anomalies grigoris f. With careful ultrasound examination associated severe complications such as hematometra andor hematosalpinx can be ruled out preoperatively. Hematometra, also known as hemometra or post abortion syndrome, is a medical term which describes an accumulation of blood clots in the uterus and affects the fertility of women. Drainage of hematometrium obgyn coding ask an expert. Hematometra, otherwise known as hemometra is a condition in which blood is collected and retained in the uterus, commonly the result of an imperforate hymen or transverse vaginal septum the physical obstruction of menstrual blood from the uterus causes a significant back up of menstrual blood over time, which can cause the uterus to enlarge, putting pressure on other pelvic organs, similar. More than 300 years ago ambroise pare described a case in which, because of amenorrhea, pain and abdominal swelling, the condition was diagnosed as pregnancy. Evaluation of anterior cervical defect with a hysteroscope would be considered as diagnostic hysteroscopy and would get bundled with 58558. Hematometra causes, symptoms, diagnosis and treatment. The hematocolpos associated with uterus didelphys can be differentiated from hematocolpos due to an imperforate hymen, by demonstration of the level of the obstruction.
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