Hematocolpometra Due to an Imperforate Hymen Presenting With Back Pain Sonographic Diagnosis

A case study of a 12-year-old presumably premenarchal girl presented to the emergency department with a 48-hour history of abdominal discomfort and back pain radiating to the level of the right scapula and increasing in the supine position, is presented. Abdominal sonography revealed a cystic mass anterior to the urinary bladder measuring 13.7 × 5.6 × 5.2 cm and containing echogenic fluid, corresponding to a distended vagina. Hymenotomy was performed, and the blood was drained from the vagina through a catheter. Hematocolpometra secondary to an imperforate hymen and retrograde menstruation is a rare entity that should be considered in the differential diagnosis of abdominal or back pain in premenarchal adolescent girls. Clinical examination can differentiate between the causes of hematocolpometra because both an imperforate hymen and a transverse vaginal septum can lead to obstruction of the vagina.