13-year old girl with acute lower abdominal pain – Gynaecology MCQ

A 13-year old girl came to the casualty with acute lower abdominal pain. She had cyclical pain for the last 6 months. She has not yet attained her menarche. On examination, a tense bulge was seen in the region of the hymen. The most probable diagnosis is?

A. Mayer-Rokitansky-Küster-Hauser syndrome
B. Imperforate hymen
C. Asherman’s syndrome
D. Congenital adrenal hyperplasia

Correct answer : B. Imperforate hymen

• Imperforate hymen prevents the drainage of menstrual blood.
• This results in the accumulation of blood in the vagina leading to hematocolpos.
• This is visualised as the tense bulge.
• In long standing cases it can even lead to hematometra.