DIAGNOSIS:
Imperforate Hymen with Hematocolpos with a Bicornuate Uterus
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Fig. 6: Coronal T2W MRI of the pelvis shows a grossly distended uterus with a thin, well-defined hypointense septum (arrows), consistent with an imperforate hymen |
Fig. 7: T2W sagittal MRI of the pelvis shows non-distension of one cornu of the uterus communicating with the endometrial cavity (arrow) of the other, distended cornu. |
The figures show a grossly distended cervix, vagina and uterinue cornu with fluid that is hyperintense on TW and hypointense on T2W images, suggestive of blood. Figures 6 and 7 show the imperforate hymen as well as distension of only one cornu of the uterus.
Imperforate hymen is a classical, although rare, easily curable cause of primary amenorrhea. It is usually associated with other congenital defects. In most cases of obstructive vaginal lesions, physical examination combined with USG is sufficient to establish a working diagnosis. Of more important long-term concern in this patient, is infertility due to her incidentally detected bicornuate uterus. In patients with complex anomalies, MRI can be used for the delineation of the exact anatomy.
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