Congenital Vaginal Atresia with Uterovaginal Hydrocolpos Causing Giant Abdominal Cyst in a Neonate: A Case Report

Congenital Vaginal Atresia with Uterovaginal Hydrocolpos Causing Giant Abdominal Cyst in a Neonate: A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Congenital Vaginal Atresia with Uterovaginal Hydrocolpos Causing Giant Abdominal Cyst in a Neonate: A Case Report Gang Wang, Bin Ma, Hongxia Tie, Yanwu Yao, Yixuan Wang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6412545/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Congenital vaginal atresia is a rare genital tract malformation that is often diagnosed during adolescence or adulthood. Neonatal cases pose particular diagnostic challenges due to their susceptibility to misdiagnosis, which may result in significant long-term consequences for fertility and quality of life. Case presentation This case describes a 2-day-old female neonate who presented with abdominal distension and persistent irritability. Initial ultrasonography misdiagnosed the condition as an intestinal duplication cyst; however, emergency surgical exploration confirmed congenital vaginal atresia with massive hydrometrocolpos. Transvaginal catheter drainage was subsequently performed, and postoperative follow-up demonstrated marked reduction of fluid accumulation. Conclusions This case underscores the critical need to consider congenital vaginal atresia and its complications in neonates presenting with nonspecific abdominal symptoms. Early recognition of this rare condition is essential to prevent diagnostic delays, reduce misdiagnosis-related morbidity, and optimize long-term reproductive and functional outcomes. Neonate Vaginal atresia Ultrasound Case Report Figures Figure 1 Figure 2 Figure 3 Background Congenital vaginal atresia is a rare genital tract malformation with an estimated incidence of 1/10,000 to 1/4,000 [1]. Its pathogenesis remains incompletely understood. Often diagnosed during adolescence or adulthood due to delayed symptom manifestation, neonatal cases are prone to misdiagnosis [2], posing challenges to fertility and quality of life. Large fluid-filled cystic lesions in such cases may mimic other intra-abdominal cystic pathologies on imaging. This report details a rare case of congenital vaginal atresia with massive uterine hydrocolpos in a 2-day-old neonate presenting with abdominal distension and irritability. The significance of this case lies in emphasizing the need to consider congenital vaginal atresia and its complications in neonates with abdominal symptoms. By sharing this case, we aim to enhance clinical awareness, promote early diagnosis, and facilitate timely intervention to improve patient outcomes. Case presentation A 2-day-old female neonate, delivered vaginally with an Apgar score of 10, presented with abdominal distension and persistent crying. Prenatal ultrasound had identified a lower abdominal cystic mass (6.5 cm × 5.8 cm), suspected to be enteric in origin. Physical examination revealed marked abdominal distension with a soft lower abdominal mass extending to 1 cm below the xiphoid process. The urethral orifice was visible, but the vaginal opening was not clearly identified. Emergency transabdominal ultrasound showed intestinal gas and a lower abdominal cystic mass (6.5 cm × 6.0 cm × 5.0 cm) with a 0.2 cm thick wall displaying characteristic intestinal wall stratification (high-low-high echogenic layers) and internal debris ( Figure 1 ). The bladder was compressed, while both kidneys appeared normal. Suspected intestinal duplication prompted laparoscopic exploration, which revealed a grossly distended uterus (6.0 cm × 6.0 cm × 5.0 cm), right hydrosalpinx, and extensive adhesions extending to the umbilicus ( Figure 2a ). The lower vagina was dilated but obstructed, confirming congenital vaginal atresia with massive uterine hydrocolpos. Ultrasound-guided uterine cavity catheter drainage was performed, yielding turbid fluid ( Figure 2b ).Postoperative ultrasound at 2 days demonstrated normal bladder filling, reduced uterine size (myometrial thickness: 0.5 cm), and a hyperechoic drainage tube within the uterine cavity ( Figure 3a ). Transperineal ultrasound revealed an inverted pear-shaped anechoic area posterior to the bladder, tapering to a blind end adjacent to the rectum ( Figure 3b ). No fluid recurrence was observed during 3-month follow-up. Discussion This case underscores the complexity of congenital vaginal atresia and its association with concurrent genital tract anomalies.This neonate’s presentation with a giant abdominal cyst masquerading as intestinal duplication highlights diagnostic challenges. Transperineal ultrasound can delineate the characteristic inverted pear-shaped cystic structure (superiorly continuous with the uterus and terminating in a blind end), aiding differentiation from other pathologies [3]. Key differential diagnoses include intestinal duplication (tubular structure with gut wall signature), sacrococcygeal teratoma (mixed echogenicity with calcifications/lipid-fluid levels), ovarian cysts (unilateral with normal uterus), and neuroblastoma (solid mass with calcifications). In this case, laparoscopic exploration combined with uterine drainage proved effective for symptom relief and anatomical restoration. Current evidence supports prompt surgical intervention, particularly in cases with severe adhesions [4,5]. The absence of recurrence during follow-up validates the efficacy of this approach. This case emphasizes that early recognition and management of congenital vaginal atresia can mitigate complications and improve long-term outcomes. Neonates presenting with large lower abdominal cystic masses should raise suspicion for vaginal atresia with hydrocolpos. Comprehensive imaging, including combined transabdominal and transperineal ultrasound, is recommended for accurate anatomical assessment and timely intervention. Conclusions This case underscores the critical importance of early identification and intervention for developmental anomalies of the reproductive system during the neonatal period. Clinical practice should place greater emphasis on early screening for abdominal pathologies in newborns, thereby reducing complications caused by delayed diagnoses. The insights from this case offer valuable references for the management of similar clinical scenarios. Declarations Acknowledgements Not applicable. Authors’ contributions Gang Wang conceived the present study. Gang Wang, Bin Ma and Yanwu Yao acquired, analyzed and interpreted the data. Gang Wang and Hongxie Tie wrote the manuscript. Yixuan Wang and Yanwu Yao critically reviewed the manuscript. All authors read and approved the final version of the manuscript. Funding This work was supported by the Science and Technology Plan Project of Gansu Province (No. 24JRRAU16). Availability of data and materials Data sharing is not applicable to this article as no datasets were generated or analysed during the current study Competing interests The authors declare that they have no competing interests. Ethics approval and consent to participate For case studies based on available clinical data, no approval by the Medical Ethics Committee of Gansu Provincial Maternity and Child-care Hospital is required. Clinical trial number: not applicable. Written informed consent was obtained from the parents of the patient. Patient consent for publication Written informed consent was obtained from the patient and her parents for publication of this report and any accompanying images. References Zhu L, Lang JH, Song L, et al.Chinese expert consensus on the diagnosis and treatment of Herlyn-Werner-Wunderlich syndrome, Mayer-Rokitansky-Küster-Hauser syndrome and vaginal atresia[J]. Chinese Journal of Obstetrics and Gynecology. 2018,53(1):35-42. Ameh EA, Mshelbwala PM, Ameh N. Congenital vaginal obstruction in neonates and infants: recognition and management[J]. J Pediatr Adolesc Gynecol. 2011,24(2):74-78. Hamed ST, Mansour SM. Surface transperineal ultrasound and vaginal abnormalities: applications and strengths. Br J Radiol[J]. 2017,90(1080):20170326. Barber Caselles C, Aguilar Cayuelas A, Yáñez F, et al. Abdominal distension and bloating: Mechanistic approach for tailored management[J]. Gastroenterol Hepatol. 2024,47(5):517-521. Committee on Adolescent Health Care. ACOG Committee Opinion No. 728: Müllerian Agenesis: Diagnosis, Management, And Treatment[J]. Obstet Gynecol. 2018,131(1):e35-e42. Additional Declarations No competing interests reported. Supplementary Files CAREchecklistEnglish2013.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6412545","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":451482738,"identity":"2336f4b8-026e-4f81-a9c7-ead0dbaf1045","order_by":0,"name":"Gang Wang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIiWNgGAWjYBACNvb+7x8S/9XU8zMcPkCcFj6eA2YMD9iOJUg2HksgToucRIIZ4wM25gSDw2cMiHQYQ0LagwQetjzJtjMfb7xhsJPTbSCo5cBxgwQJmWJ+nrObLecwJBubHSCkhbGxQSLBgI1x5oyz26R5GA4kbiOohZmZQSIhgZlxw/03z4jUAgQSCQeYEzccOMNGpBYeHmaDxIZjxpJAbDnHgAi/yM9/w/jwZ0ONHDAqH954U2EnR1ALCpDgITJqkLWQqmMUjIJRMApGBAAA94BDUDU8i/8AAAAASUVORK5CYII=","orcid":"","institution":"Ultrasound Medicine Center, Gansu Provincial Maternity and Child-care Hospital","correspondingAuthor":true,"prefix":"","firstName":"Gang","middleName":"","lastName":"Wang","suffix":""},{"id":451482739,"identity":"79f6cc24-85cb-426c-80e8-5759f306a8ec","order_by":1,"name":"Bin Ma","email":"","orcid":"","institution":"Ultrasound Medicine Center, Gansu Provincial Maternity and Child-care Hospital","correspondingAuthor":false,"prefix":"","firstName":"Bin","middleName":"","lastName":"Ma","suffix":""},{"id":451482740,"identity":"e367969c-4537-41db-94a4-d2bca95c7076","order_by":2,"name":"Hongxia Tie","email":"","orcid":"","institution":"Ultrasound Medicine Center, Gansu Provincial Maternity and Child-care Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hongxia","middleName":"","lastName":"Tie","suffix":""},{"id":451482741,"identity":"a030228c-cebf-4a17-b3f5-e0f63db7ea89","order_by":3,"name":"Yanwu Yao","email":"","orcid":"","institution":"Ultrasound Medicine Center, Gansu Provincial Maternity and Child-care Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yanwu","middleName":"","lastName":"Yao","suffix":""},{"id":451482742,"identity":"a6867d17-dc48-46f9-950b-2af749dcd1a2","order_by":4,"name":"Yixuan Wang","email":"","orcid":"","institution":"Ultrasound Medicine Center, Gansu Provincial Maternity and Child-care Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yixuan","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2025-04-09 13:53:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6412545/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6412545/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82177231,"identity":"e523bb35-b062-48fa-9bfa-7b40031ab299","added_by":"auto","created_at":"2025-05-07 11:20:02","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":93634,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePreoperative Ultrasound Examination\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA giant cystic mass in the lower abdomen demonstrating characteristic bowel wall stratification (hyper-hypo-hyperechoic layers)（white arrow）with intraluminal echogenic debris.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6412545/v1/7fff209a9340fc1fc2d6cfce.png"},{"id":82175951,"identity":"59c8312e-38ef-4c49-a11f-ba96a4dc93c4","added_by":"auto","created_at":"2025-05-07 11:12:02","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":387965,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eIntraoperative imaging\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ea: Uterus markedly distended (white arrow), Significant dilatation of the right fallopian tube (yellow arrow); b: turbid cystic fluid.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6412545/v1/7c93402e2ca96a5d02d0dbe7.png"},{"id":82177232,"identity":"7821fcea-2496-4407-a45d-8615bcba1aac","added_by":"auto","created_at":"2025-05-07 11:20:02","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":148408,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePostoperative ultrasound examination\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ea: Well-distended bladder with posterior uterine fluid collection and intrauterine hyperechoic drainage catheter(white arrow). b:Blind end of the lower part of the vagina with fluid accumulation in the vagina (red arrow).\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-6412545/v1/31b1e98d1bc465029fd157e5.png"},{"id":91519944,"identity":"011c0d5f-83f1-46c0-93cf-146e57927a10","added_by":"auto","created_at":"2025-09-17 10:02:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1208264,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6412545/v1/53625df0-aef0-4691-a9a7-c028ef53a832.pdf"},{"id":82175953,"identity":"504cc1ec-6a7a-4cf0-8e3b-5834946ac4e0","added_by":"auto","created_at":"2025-05-07 11:12:02","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":634038,"visible":true,"origin":"","legend":"","description":"","filename":"CAREchecklistEnglish2013.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6412545/v1/92e942db0a838b60515287ea.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Congenital Vaginal Atresia with Uterovaginal Hydrocolpos Causing Giant Abdominal Cyst in a Neonate: A Case Report","fulltext":[{"header":"Background","content":"\u003cp\u003eCongenital vaginal atresia is a rare genital tract malformation with an estimated incidence of 1/10,000 to 1/4,000 [1]. Its pathogenesis remains incompletely understood. Often diagnosed during adolescence or adulthood due to delayed symptom manifestation, neonatal cases are prone to misdiagnosis [2], posing challenges to fertility and quality of life. Large fluid-filled cystic lesions in such cases may mimic other intra-abdominal cystic pathologies on imaging. This report details a rare case of congenital vaginal atresia with massive uterine hydrocolpos in a 2-day-old neonate presenting with abdominal distension and irritability. The significance of this case lies in emphasizing the need to consider congenital vaginal atresia and its complications in neonates with abdominal symptoms. By sharing this case, we aim to enhance clinical awareness, promote early diagnosis, and facilitate timely intervention to improve patient outcomes.\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eA 2-day-old female neonate, delivered vaginally with an Apgar score of 10, presented with abdominal distension and persistent crying. Prenatal ultrasound had identified a lower abdominal cystic mass (6.5 cm\u0026nbsp;\u0026times; 5.8 cm), suspected to be enteric in origin. Physical examination revealed marked abdominal distension with a soft lower abdominal mass extending to 1 cm below the xiphoid process. The urethral orifice was visible, but the vaginal opening was not clearly identified. Emergency transabdominal ultrasound showed intestinal gas and a lower abdominal cystic mass (6.5 cm \u0026times; 6.0 cm \u0026times; 5.0 cm) with a 0.2 cm thick wall displaying characteristic intestinal wall stratification (high-low-high echogenic layers) and internal debris (\u003cstrong\u003eFigure 1\u003c/strong\u003e). The bladder was compressed, while both kidneys appeared normal. Suspected intestinal duplication prompted laparoscopic exploration, which revealed a grossly distended uterus (6.0 cm \u0026times; 6.0 cm \u0026times; 5.0 cm), right hydrosalpinx, and extensive adhesions extending to the umbilicus (\u003cstrong\u003eFigure 2a\u003c/strong\u003e). The lower vagina was dilated but obstructed, confirming congenital vaginal atresia with massive uterine hydrocolpos. Ultrasound-guided uterine cavity catheter drainage was performed, yielding turbid fluid (\u003cstrong\u003eFigure 2b\u003c/strong\u003e).Postoperative ultrasound at 2 days demonstrated normal bladder filling, reduced uterine size (myometrial thickness: 0.5 cm), and a hyperechoic drainage tube within the uterine cavity (\u003cstrong\u003eFigure 3a\u003c/strong\u003e). Transperineal ultrasound revealed an inverted pear-shaped anechoic area posterior to the bladder, tapering to a blind end adjacent to the rectum (\u003cstrong\u003eFigure 3b\u003c/strong\u003e). No fluid recurrence was observed during 3-month follow-up.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis case underscores the complexity of congenital vaginal atresia and its association with concurrent genital tract anomalies.This neonate\u0026rsquo;s presentation with a giant abdominal cyst masquerading as intestinal duplication highlights diagnostic challenges. Transperineal ultrasound can delineate the characteristic inverted pear-shaped cystic structure (superiorly continuous with the uterus and terminating in a blind end), aiding differentiation from other pathologies [3]. Key differential diagnoses include intestinal duplication (tubular structure with gut wall signature), sacrococcygeal teratoma (mixed echogenicity with calcifications/lipid-fluid levels), ovarian cysts (unilateral with normal uterus), and neuroblastoma (solid mass with calcifications).\u003c/p\u003e\n\u003cp\u003eIn this case, laparoscopic exploration combined with uterine drainage proved effective for symptom relief and anatomical restoration. Current evidence supports prompt surgical intervention, particularly in cases with severe adhesions [4,5]. The absence of recurrence during follow-up validates the efficacy of this approach.\u003c/p\u003e\n\u003cp\u003eThis case emphasizes that early recognition and management of congenital vaginal atresia can mitigate complications and improve long-term outcomes. Neonates presenting with large lower abdominal cystic masses should raise suspicion for vaginal atresia with hydrocolpos. Comprehensive imaging, including combined transabdominal and transperineal ultrasound, is recommended for accurate anatomical assessment and timely intervention.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis case underscores the critical importance of early identification and intervention for developmental anomalies of the reproductive system during the neonatal period. Clinical practice should place greater emphasis on early screening for abdominal pathologies in newborns, thereby reducing complications caused by delayed diagnoses. The insights from this case offer valuable references for the management of similar clinical scenarios.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGang Wang conceived the present study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGang Wang, Bin Ma and Yanwu Yao acquired, analyzed and interpreted the data.\u003c/p\u003e\n\u003cp\u003eGang Wang and Hongxie Tie wrote the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eYixuan Wang and Yanwu Yao critically reviewed the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Science and Technology Plan Project of Gansu Province (No. 24JRRAU16).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData sharing is not applicable to this article as no datasets were generated or analysed during the current study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor case studies based on available clinical data, no approval by the Medical Ethics Committee of\u0026nbsp;Gansu Provincial Maternity and Child-care Hospital\u0026nbsp;is required.\u0026nbsp;Clinical trial number: not applicable. Written informed consent was obtained from the parents of the patient.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient consent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the patient and her parents for publication of this report and any accompanying images.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eZhu L, Lang JH, Song L, et al.Chinese expert consensus on the diagnosis and treatment of Herlyn-Werner-Wunderlich syndrome, Mayer-Rokitansky-K\u0026uuml;ster-Hauser syndrome and vaginal atresia[J]. Chinese Journal of Obstetrics and Gynecology. 2018,53(1):35-42.\u003c/li\u003e\n \u003cli\u003eAmeh EA, Mshelbwala PM, Ameh N. Congenital vaginal obstruction in neonates and infants: recognition and management[J]. J Pediatr Adolesc Gynecol. 2011,24(2):74-78.\u003c/li\u003e\n \u003cli\u003eHamed ST, Mansour SM. Surface transperineal ultrasound and vaginal abnormalities: applications and strengths. Br J Radiol[J]. 2017,90(1080):20170326.\u003c/li\u003e\n \u003cli\u003eBarber Caselles C, Aguilar Cayuelas A, Y\u0026aacute;\u0026ntilde;ez F, et al. Abdominal distension and bloating: Mechanistic approach for tailored management[J]. Gastroenterol Hepatol. 2024,47(5):517-521.\u003c/li\u003e\n \u003cli\u003eCommittee on Adolescent Health Care. ACOG Committee Opinion No. 728: M\u0026uuml;llerian Agenesis: Diagnosis, Management, And Treatment[J]. Obstet Gynecol. 2018,131(1):e35-e42.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Neonate, Vaginal atresia,Ultrasound, Case Report","lastPublishedDoi":"10.21203/rs.3.rs-6412545/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6412545/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003eCongenital vaginal atresia is a rare genital tract malformation that is often diagnosed during adolescence or adulthood. Neonatal cases pose particular diagnostic challenges due to their susceptibility to misdiagnosis, which may result in significant long-term consequences for fertility and quality of life.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase presentation \u003c/strong\u003eThis case describes a 2-day-old female neonate who presented with abdominal distension and persistent irritability. Initial ultrasonography misdiagnosed the condition as an intestinal duplication cyst; however, emergency surgical exploration confirmed congenital vaginal atresia with massive hydrometrocolpos. Transvaginal catheter drainage was subsequently performed, and postoperative follow-up demonstrated marked reduction of fluid accumulation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions \u003c/strong\u003eThis case underscores the critical need to consider congenital vaginal atresia and its complications in neonates presenting with nonspecific abdominal symptoms. Early recognition of this rare condition is essential to prevent diagnostic delays, reduce misdiagnosis-related morbidity, and optimize long-term reproductive and functional outcomes.\u003c/p\u003e","manuscriptTitle":"Congenital Vaginal Atresia with Uterovaginal Hydrocolpos Causing Giant Abdominal Cyst in a Neonate: A Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-07 11:11:58","doi":"10.21203/rs.3.rs-6412545/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c31e9cc6-95a3-49f0-ac2b-fc7ff00495d6","owner":[],"postedDate":"May 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-17T09:53:51+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-07 11:11:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6412545","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6412545","identity":"rs-6412545","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}