Sonographic findings in a case of uterine and vaginal duplication (didelphys) with unilateral hematocolpometrasalpinx

✍ Scribed by William Stangl; Ralph C. Frank; William Frank; Steve Nelli

• Publisher: John Wiley and Sons
• Year: 1983
• Tongue: English
• Weight: 205 KB
• Volume: 11
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870110111

✦ Synopsis

Uterine, vaginal, and even oviduct distention due to accumulation of menstrual discharges may occur because of an imperforate hymen or other anomalies that prevent normal vaginal discharge. Ordinarily, the condition is not detected until puberty, with the onset of the menstrual cycle, although an infantile hydrocolpometra can occur in these cases if uterine and vaginal secretions are stimulated by maternal estrogen production. Pre-and postoperative sonographic evaluation can provide the attending physician with invaluable diagnostic information. Surgical verification in the case reported here demonstrated the accuracy of diagnostic ultrasound with regard to the echo pattern, size, and shape in evaluating the pathology.

CASE REPORT

A 13-yr-old girl presented with acute lower abdominal pain bilaterally, more intense in the left lower quadrant, and radiating t o the back. Nausea and vomiting occurred, and a large pelvic mass was palpable.

Since the onset of menarche, the patient's menstrual periods have been regular, occurring every 23 days and lasting for six days, but with progressively increasing dysmenorrhea accompanying each successive menstrual cycle. Sonographic evaluation was requested.

At normal gain settings, a large, lobulated, smooth-wall, sonolucent mass with good through transmission was demonstrated (Fig 1). At slightly higher gain settings, the mass appeared