Ultrasound Findings in a Case of Hematocolpometrosalpinx in an Eleven Year Old Kenyan Girl

In this case, an 11 years old female presented to our hospital with recurrent cramping lower abdominal pains for three consecutive months. She denied any history neither of dysuria nor per vaginal discharge. There was no history of sexual contact or sexual assault.  Prior to coming to our hospital, she had undergone treatment for lower urinary tract infection on a clinical basis without improvement. The doctor at our hospital facility ordered for an abdominal ultrasound and urinalysis tests. The urine was 0-5pus cells/hpf , nil protein, nil glucose, nil nitrite, and had a specific gravity of 1010. The ultrasound revealed free fluid collection with low-level internal echoes in the endometrial cavity that extended into the vagina with a bulging membrane and also extended to be involving the fallopian tubes that were visualized as dilated fluid-filled structures with surrounding free fluid in the adnexae.  This was then diagnosed as a severe case of haematometrocolpos that involved the fallopian tubes thus qualifying it to be haematosalpingometrocolpos or haematocolpometrosalpinx. Haematocolpometrosalpinx is a collection of blood and fluid within the fallopian tubes, uterus, and vagina. This condition is usually due to acquired or congenital anomalies of the uterus and vagina. It can present in children, adolescent females or adult females. Patients may be asymptomatic or can present with vague pelvic discomfort or pain during defecation or urination due to pressure on the rectum or bladder by the pelvic mass. Pelvic ultrasound is an important diagnostic tool in evaluating the cause of unexplained recurrent lower abdominal pains in adolescent and pre-adolescent females. Following Hymenectomy, the patient commenced normal menses with no pain in the subsequent months.