Recurrent hematometra with endometriosis in an adolescent girl: a case report

Sarita Agrawal, Rajshree Sahu, Pushpawati Thakur, Vinita Singh, Pawan B. Chandramohan
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2019 · vol. 8(11) , pp. 4567 · doi:10.18203/2320-1770.ijrcog20194895 · W2982243263
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This case report details the successful hysteroscopic management of hematometra with endometriosis secondary to cervical stenosis in an adolescent girl.

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This case report describes an adolescent girl presenting with recurrent hematometra and endometriosis secondary to cervical stenosis, a condition where blood accumulates in the uterine cavity due to outflow tract obstruction. The diagnosis was complicated by the atypical presentation of amenorrhea rather than the primary amenorrhea usually associated with cervical stenosis. Successful management was achieved through hysteroscopic cervical dilatation under ultrasound guidance followed by transcervical catheter insertion to prevent restenosis. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Hematometra is a collection or retention of blood in the uterine cavity. This condition is most commonly associated with congenital uterine anomalies that result from abnormal formation, fusion or resorption of Mullerian ducts during fetal life or may be due to prior surgical procedures, causing an obstruction of the genitourinary outflow tract. We report an unusual case of hematometra with endometriosis secondary to cervical stenosis. This is a rare and important case report due to the complexity of diagnosis as cervical stenosis was not presented as primary amenorrhoea as its usual presentation. This case was successfully managed by Hysteroscopic cervical dilatation under USG guidance followed by transcervical insertion of a catheter to prevent recurrent stenosis.
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Recurrent hematometra with endometriosis in an adolescent girl: a case report DOI: https://doi.org/10.18203/2320-1770.ijrcog20194895Keywords: Amenorrhoea, Cervical stenosis, Endometriosis, Hemetometra, Mullerian duct, Uterine anomalyAbstract Hematometra is a collection or retention of blood in the uterine cavity. This condition is most commonly associated with congenital uterine anomalies that result from abnormal formation, fusion or resorption of Mullerian ducts during fetal life or may be due to prior surgical procedures, causing an obstruction of the genitourinary outflow tract. We report an unusual case of hematometra with endometriosis secondary to cervical stenosis. This is a rare and important case report due to the complexity of diagnosis as cervical stenosis was not presented as primary amenorrhoea as its usual presentation. This case was successfully managed by Hysteroscopic cervical dilatation under USG guidance followed by transcervical insertion of a catheter to prevent recurrent stenosis. Metrics References Xie Z, Zhang X, Liu J, Zhang N, Xiao H, Liu Y, et al. Clinical characteristics of congenital cervical atresia based on anatomy and ultrasound: a retrospective study of 32 cases. Eu J Med Res. 2014;19(1):10. Bettocchi S, Bramante S, Bifulco G, Spinelli M, Ceci O, Fascilla FD, et al. Challenging the cervix: strategies to overcome the anatomic impediments to hysteroscopy: analysis of 31,052 office hysteroscopies. Fertil Steril. 2016;105(5):e16-7. Rezai S, Lieberman D, Caton K, Semple S, Henderson CE. Hematometra and hematocolpos, secondary to cervical canal occlusion, a case report and review of literature. Obstet GynecolInt J. 2017;6(3):00208. Skopec GS. A review of medical and surgical techniques for overcoming cervical stenosis. Proc Obstet Gynecol. 2018;8(1):7.

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