PDF(Pubmed)
Abstract：
BACKGROUND: Imperforate hymen is the most common congenital defect of the female urogenital tract. The spectrum of clinical manifestations is broad, ranging from mild cases undiagnosed until adolescence to severe cases of giant intraabdominal masses. The most common complication of hydrocolpos is bladder compression, resulting in obstructive uropathy and hydronephrosis.
METHODS: We present here the case of a preterm neonate who was admitted to the surgical neonatal intensive care unit for bowel obstruction. The baby did not appear septic or unwell, a small amount of meconium passed frequently, and no bilious gastric residuals occurred. Based on these findings, acute abdominal obstruction was doubtful, and the surgeon chose a conservative (watch and wait) approach. Subsequently, we performed abdominal ultrasound and magnetic resonance imaging based on unclear information about a suspicious abdominal mass raised by the gynecologist shortly before the emergency C-section. The final diagnosis was congenital hydrocolpos due to imperforate hymen. The pediatric gynecologist indicated an incision of the imperforate hymen under general anesthesia. The incision resolved abdominal distention as well as the bowel obstruction.
CONCLUSIONS: The presentation of hydrocolpos was not typical (no bulging in the vaginal introitus) in our case, and clinical symptoms implied acute bowel obstruction shortly after birth. The surgeon chose a conservative (watch and wait) approach as the baby did not appear unwell on the second day of life. Fortunately, diagnostic laparotomy was not required as the next step in bowel obstruction management. All clinical symptoms resolved after a minor surgical procedure.
METHODS: We present here the case of a preterm neonate who was admitted to the surgical neonatal intensive care unit for bowel obstruction. The baby did not appear septic or unwell, a small amount of meconium passed frequently, and no bilious gastric residuals occurred. Based on these findings, acute abdominal obstruction was doubtful, and the surgeon chose a conservative (watch and wait) approach. Subsequently, we performed abdominal ultrasound and magnetic resonance imaging based on unclear information about a suspicious abdominal mass raised by the gynecologist shortly before the emergency C-section. The final diagnosis was congenital hydrocolpos due to imperforate hymen. The pediatric gynecologist indicated an incision of the imperforate hymen under general anesthesia. The incision resolved abdominal distention as well as the bowel obstruction.
CONCLUSIONS: The presentation of hydrocolpos was not typical (no bulging in the vaginal introitus) in our case, and clinical symptoms implied acute bowel obstruction shortly after birth. The surgeon chose a conservative (watch and wait) approach as the baby did not appear unwell on the second day of life. Fortunately, diagnostic laparotomy was not required as the next step in bowel obstruction management. All clinical symptoms resolved after a minor surgical procedure.
摘要：
背景：处女膜穿孔是女性泌尿生殖道最常见的先天性缺损。临床表现的范围很广，从轻度未诊断到青春期的病例到严重的巨大腹内肿块。积水最常见的并发症是膀胱压迫，导致尿路梗阻和肾积水.
方法：我们在此介绍一例早产新生儿因肠梗阻进入外科新生儿重症监护病房的病例。婴儿没有出现败血症或不适，少量的胎粪经常通过，没有胆汁性胃残留物发生。基于这些发现,急性腹部梗阻值得怀疑，外科医生选择了保守的（观察和等待）方法。随后，我们根据妇科医生在急诊剖腹产前不久提出的可疑腹部肿块的不明确信息,进行了腹部超声和磁共振成像.最终诊断是由于处女膜无孔引起的先天性积水。小儿妇科医生指出在全身麻醉下切开了无孔处女膜。切口解决了腹胀和肠梗阻。
结论：在我们的病例中，积水的表现并不典型（在阴道口没有隆起），临床症状提示出生后不久出现急性肠梗阻。外科医生选择了保守的（观察和等待）方法，因为婴儿在生命的第二天没有出现不适。幸运的是,诊断性剖腹手术不需要作为肠梗阻治疗的下一步.小手术后，所有临床症状均得到缓解。
方法：我们在此介绍一例早产新生儿因肠梗阻进入外科新生儿重症监护病房的病例。婴儿没有出现败血症或不适，少量的胎粪经常通过，没有胆汁性胃残留物发生。基于这些发现,急性腹部梗阻值得怀疑，外科医生选择了保守的（观察和等待）方法。随后，我们根据妇科医生在急诊剖腹产前不久提出的可疑腹部肿块的不明确信息,进行了腹部超声和磁共振成像.最终诊断是由于处女膜无孔引起的先天性积水。小儿妇科医生指出在全身麻醉下切开了无孔处女膜。切口解决了腹胀和肠梗阻。
结论：在我们的病例中，积水的表现并不典型（在阴道口没有隆起），临床症状提示出生后不久出现急性肠梗阻。外科医生选择了保守的（观察和等待）方法，因为婴儿在生命的第二天没有出现不适。幸运的是,诊断性剖腹手术不需要作为肠梗阻治疗的下一步.小手术后，所有临床症状均得到缓解。
