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Hematometrocolpos
Barton F. Lane, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Hematometra (HM): Distention of uterine cavity by blood products
                • Hematocolpos (HC): Distention of vagina by blood products
                • Hematometrocolpos: Distention of uterus and vagina by accumulated blood
                • Müllerian duct anomaly (MDA): Series of uterine malformations as result of abnormal fusion of müllerian ducts
                  • Unicornuate, bicornuate, didelphys uterus ± cervical/vaginal malformation
                • Cloacal malformation (CM): Confluence of rectum vagina and urethra into single common channel

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • MR Findings

                    • CT Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Tanitame K et al: Congenital anomalies causing hemato/hydrocolpos: imaging findings, treatments, and outcomes. Jpn J Radiol. ePub, 2021
                                        2. Teo SY et al: A systematic approach to imaging the pelvis in amenorrhea. Abdom Radiol (NY). ePub, 2021
                                        3. Wang YF et al: Mimics of malignancy caused by concurrent imperforate hymen and transverse vaginal septum: an instructive case and review of the literature. J Int Med Res. 49(5):3000605211014797, 2021
                                        4. Sakhel K et al: Begin with the basics: role of 3-dimensional sonography as a first-line imaging technique in the cost-effective evaluation of gynecologic pelvic disease. J Ultrasound Med. 32(3):381-8, 2013
                                        5. Behr SC et al: Imaging of müllerian duct anomalies. Radiographics. 32(6):E233-50, 2012
                                        6. Marcal L et al: Mullerian duct anomalies: MR imaging. Abdom Imaging. 36(6):756-64, 2011
                                        7. Drakonaki EE et al: Hematocolpometra due to an imperforate hymen presenting with back pain: sonographic diagnosis. J Ultrasound Med. 29(2):321-2, 2010
                                        8. Junqueira BL et al: Müllerian duct anomalies and mimics in children and adolescents: correlative intraoperative assessment with clinical imaging. Radiographics. 29(4):1085-103, 2009
                                        9. Johnston-MacAnanny EB et al: Diagnosis and treatment of a communicating uterus didelphys with an atretic hemivagina: utility of 3-dimensional and intraoperative sonography. J Ultrasound Med. 27(6):975-8, 2008
                                        10. Orazi C et al: Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr Radiol. 37(7):657-65, 2007
                                        11. Dane C et al: Imperforate hymen-a rare cause of abdominal pain: two cases and review of the literature. J Pediatr Adolesc Gynecol. 20(4):245-7, 2007
                                        12. Sherer DM et al: Acquired hematometra and hematotrachelos in an adolescent with dysfunctional uterine bleeding. J Ultrasound Med. 25(12):1599-602, 2006
                                        13. Prada Arias M et al: Uterus didelphys with obstructed hemivagina and multicystic dysplastic kidney. Eur J Pediatr Surg. 15(6):441-5, 2005
                                        14. Warne SA et al: Long-term gynecological outcome of patients with persistent cloaca. J Urol. 170(4 Pt 2):1493-6, 2003
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Hematometra (HM): Distention of uterine cavity by blood products
                                                      • Hematocolpos (HC): Distention of vagina by blood products
                                                      • Hematometrocolpos: Distention of uterus and vagina by accumulated blood
                                                      • Müllerian duct anomaly (MDA): Series of uterine malformations as result of abnormal fusion of müllerian ducts
                                                        • Unicornuate, bicornuate, didelphys uterus ± cervical/vaginal malformation
                                                      • Cloacal malformation (CM): Confluence of rectum vagina and urethra into single common channel

                                                    IMAGING

                                                    • General Features

                                                      • Ultrasonographic Findings

                                                        • MR Findings

                                                          • CT Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Tanitame K et al: Congenital anomalies causing hemato/hydrocolpos: imaging findings, treatments, and outcomes. Jpn J Radiol. ePub, 2021
                                                                              2. Teo SY et al: A systematic approach to imaging the pelvis in amenorrhea. Abdom Radiol (NY). ePub, 2021
                                                                              3. Wang YF et al: Mimics of malignancy caused by concurrent imperforate hymen and transverse vaginal septum: an instructive case and review of the literature. J Int Med Res. 49(5):3000605211014797, 2021
                                                                              4. Sakhel K et al: Begin with the basics: role of 3-dimensional sonography as a first-line imaging technique in the cost-effective evaluation of gynecologic pelvic disease. J Ultrasound Med. 32(3):381-8, 2013
                                                                              5. Behr SC et al: Imaging of müllerian duct anomalies. Radiographics. 32(6):E233-50, 2012
                                                                              6. Marcal L et al: Mullerian duct anomalies: MR imaging. Abdom Imaging. 36(6):756-64, 2011
                                                                              7. Drakonaki EE et al: Hematocolpometra due to an imperforate hymen presenting with back pain: sonographic diagnosis. J Ultrasound Med. 29(2):321-2, 2010
                                                                              8. Junqueira BL et al: Müllerian duct anomalies and mimics in children and adolescents: correlative intraoperative assessment with clinical imaging. Radiographics. 29(4):1085-103, 2009
                                                                              9. Johnston-MacAnanny EB et al: Diagnosis and treatment of a communicating uterus didelphys with an atretic hemivagina: utility of 3-dimensional and intraoperative sonography. J Ultrasound Med. 27(6):975-8, 2008
                                                                              10. Orazi C et al: Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr Radiol. 37(7):657-65, 2007
                                                                              11. Dane C et al: Imperforate hymen-a rare cause of abdominal pain: two cases and review of the literature. J Pediatr Adolesc Gynecol. 20(4):245-7, 2007
                                                                              12. Sherer DM et al: Acquired hematometra and hematotrachelos in an adolescent with dysfunctional uterine bleeding. J Ultrasound Med. 25(12):1599-602, 2006
                                                                              13. Prada Arias M et al: Uterus didelphys with obstructed hemivagina and multicystic dysplastic kidney. Eur J Pediatr Surg. 15(6):441-5, 2005
                                                                              14. Warne SA et al: Long-term gynecological outcome of patients with persistent cloaca. J Urol. 170(4 Pt 2):1493-6, 2003