A case of image-guided hematometrocolpos drainage requiring tissue plasminogen activator in a pediatric patient

Author:

Sharma Pareena1,Shah Jay2,Sokkary Nancy3

Affiliation:

1. Department of Medicine, Medical College of Georgia of Augusta University , 1120 15th St, Augusta, GA 30912 , United States

2. Department of Radiology, Emory School of Medicine/Children’s Healthcare of Atlanta , James B. Williams Medical Education Building 100 Woodruff Circle Atlanta, GA 30322 , United States

3. Department of Obstetrics and Gynecology, Emory School of Medicine/Children’s Healthcare of Atlanta , James B. Williams Medical Education Building 100 Woodruff Circle Atlanta, GA 30322 , United States

Abstract

Abstract Hematometrocolpos (HMC) is a rare disorder that occurs when an anatomical anomaly like imperforate hymen causes menstrual blood to be retained in the uterus and vagina. There is no standard of care established for HMC beyond urgent vaginoplasty which requires a demanding post-operative course that may not be suited for all pediatric patients. This is a case report of successful use of image-guided percutaneous drainage of HMC with tissue plasminogen activator (TPA) followed by vaginoplasty in a 13-year-old female with lower vaginal atresia. Additionally, this case explores the role of menstrual suppression and the need for individualized guidelines. It emphasizes the potential of image-guided percutaneous drainage with TPA as a promising, less-invasive treatment option for pediatric HMC as well as the impact on follow-up surgery.

Publisher

Oxford University Press (OUP)

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