Abdominal sepsis as a secondary complication in the management of a teenage patient with an imperforate hymen Sepsis abdominal como complicación secundaria al manejo de una paciente adolescente con himen imperforado
Academic Article in Scopus
Background: It is estimated that about 7% of adolescents have anatomical alterations of the reproductive system, with the imperforate hymen being the most frequent of them. Due to the delay in gynecological exploration in adolescents, management is deferred and a wide spectrum of complications associated with obstruction of menstrual flow can be presented. Case: A female of 12 years of age goes to the emergency department of a second level hospital due to cyclical abdominal pain which is managed by a family doctor with analgesics and prokinetics without presenting improvement. Imaging studies and physical exploration are conducted, diagnosing imperforate hymen. The gynecology department was interconsulted in a tertiary hospital, where it performed an aspiration of 50 ml of the vaginal content in an outpatient manner, differing the surgical approach. She is presented after 7 days in his usual emergency service with infection data. Hymenotomy is performed to drain vaginal contents and antibiotic therapy is started, without improvement. 72 hours later, when presenting sepsis data, a laparoscopic approach was done, finding a pelvic abscess. Conclusion: In patients with primary amenorrhea and cyclic pelvic pain, it is important to bear in mind the anatomical abnormalities of the genitourinary tract, which should be handled by a specialist. In the case of imperforate hymen and hematocolpos, it is crucial to know surgical management by hymenotomy to avoid complications.
