The Dangers of Hymenotomy for Imperforate Hymen: A Case of Iatrogenic Pelvic Inflammatory Disease with Pyosalpinx

Jennifer W H Wong, Jennifer Wong, Wong JWH, Sherry Siarezi, Siarezi S
Journal of pediatric and adolescent gynecology · 2019 · vol. 32(4) , pp. 432–435 · doi:10.1016/j.jpag.2019.04.002 · PMID:30974214 · W2939264504
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This case report details iatrogenic pelvic inflammatory disease with pyosalpinx resulting from hymenotomy surgery for an imperforate hymen.

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Abstract

BackgroundComplications associated with imperforate hymen include cyclical abdominal pain, acute urinary retention, endometriosis, and even iatrogenic infections.CaseA 14-year-old young woman was diagnosed with an imperforate hymen, hematocolpos, and right hematosalpinx. A hymenotomy was performed, followed by a hymenectomy 3 days later. On postoperative day 7, she was admitted for pelvic inflammatory disease with a right pyosalpinx. The infection was refractory to intravenous gentamicin, ampicillin, and clindamycin so the patient underwent computed tomography-guided drainage of the pyosalpinx. Two days later, she was discharged home in good condition.Summary and conclusionSmall incisions and punctures into imperforate hymens without immediate definitive management should be avoided because inoculation of the newly introduced bacteria can ascend the gynecologic tract and lead to serious infections.

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MeSH descriptors

Colpotomy Hematocolpos Hymen Menstruation Disturbances Salpingitis Adolescent Colpotomy Congenital Abnormalities Drainage Drainage Female Hematocolpos Hematocolpos Humans Hymen Hymen Iatrogenic Disease Menstruation Disturbances Menstruation Disturbances Salpingitis

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