İsmail YILMAZ, Melike PÜNDÜK YILMAZ, Cemile ÖZCAN UÇAR

İmperfore himen olgu sunumu

İmperfore himen genellikle adölesan dönemde ortaya çıkan Müllerian kanal anomalisidir. Ergenlik döneminde ağrı, hematokolpometra ve primer amenore ile kendini gösterir. Tedavi edilmeyen hastalarda endometriozis ve infertilite gibi ciddi komplikasyonlar gelişebilir. İmperfore himenin tedavi yöntemi himenektomi ya da himenotomidir. Olgumuz, 11 yaşında kız çocuğu, bakire, primer amenoreli olup karın ağrısı şikâyetiyle acil servisten başvurmuş, yapılan fizik muayene ve görüntüleme yöntemleri sonucundan imperfore himen tanısı almıştır. Cerrahi yöntem ile himene horizontal ve vertikal birer santimetrelik kesi yapılmıştır. Yaklaşık 400 cc eski kanamaya ait materyal aspire edilmiştir. Himen ağzı dört bölgeden 2.0 rapid vicryl ile dışarı ağızlaştırılmıştır. Sonuç olarak, karın ağrısı ile başvuran, primer amenoreli adölesanlarda altta yatan imperfore himen olasılığı göz önünde bulundurulmalıdır.

Imperfore hymen case report

Imperforate hymen is a Mullerian duct anomaly that usually occurs in the adolescent period. Pain during adolescence is manifested by hematocolpometra and primary amenorrhea. Serious complications such as endometriosis and infertility may develop in untreated patients. The treatment method of imperforate hymen is hymenectomy or hymenotomy. Our case is an 11-year-old woman, virgin, with primary amenorrhea and admitted to the emergency department with the complaint of abdominal pain and was diagnosed with imperforate hymen as a result of physical examination and imaging methods. A horizontal and vertical one cm incision was made with the surgical method. Approximately 400 cc of old bleeding material was aspirated. The hymen mouth was sutured from four regions with 2.0 rapid vicryl. Consequently, the possibility of underlying imperforate hymen should be considered in adolescents with primary amenorrhea presenting with abdominal pain.

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1. Winderl LM, Silverman RK. Prenatal diagnosıs of congenital imperforate hymen. Obstetrics & Gynecology. 1995; 85 (5): 857- 60.
2. Heger AH, Ticson L, Guerra L, et al. Appearance of the genitalia in girls selected for nonabuse: review of hymenal morphology and nonspecific findings. J Pediatr Adolesc Gynecol. 2002; 15 (1): 27-35.
3. Coppola L. Unique case of imperforate hymen. North American Society for Pediatric and Adolescent Gynecology. 2015: 1-3.
4. Ossman AME, El- Masry YI, El- Namoury MM, Sarsik SM. Spontaneous reformation of imperforate hymen after repeated hymenectomy. Journal of Pediatric and Adolescent Gynecology. 2016; 29 (5): 63- 5.
5. Tekin YB, Güven ESG, Şahin FK. İmperfore hymen sekonder oluşan pelvik kitlenin hymen kouyucu cerrahi ile tedavisi. Ege Tıp Dergisi. 2016; 55 (1): 29-31.
6. Wong, J.W.H., Siarezi, S. (2019). The Dangers of hymenotomy for imperforate hymen: A case of latrogenic pelvic inflammatory disease with pyosalpinx. Journal of Pediatric and Adolescent Gynecology. 432-435. https://doi.org/10.1016/j.jpag.2019.04.002.
7. Abraham, C. (2019). İmperforate hymen causıng hematocolpos and urınary retention. The Journal of Emergency Medicine, 1-3. https://doi.org/10.1016/j.jemermed.2019.03.014.
8. Sorrentino F, Angioni S, Pontis A, Greco F, Scutiero G, Nappi L. Laparoscopically assisted treatment of imperforate hymen in a patient with ventriculo- peritoneal (VP) shunt for congenital hydrocephalous: A case report. International Journal of Surgery Open. 2018: 66- 8.
9. Doğan ÖF, Şentürk M, Aslan S, Öge T, Aydın Y. Abdominal kitle ile başvuran imperfore himen olgusu. Osmangazi Tıp Dergisi. 2014; 36 (3): 1-4.