Abstract
A 10-year-old girl complaining of lower abdominal pain and urinary retention was admitted to the pediatric emergency department. From the abdominal X-ray image, we suspected a lower abdominal tumor. However, abdominal ultrasonography revealed a distended bladder. On urethral catheterization, we detected a bulging imperforate hymen. The patient underwent surgery, which involved a circular incision of the hymen, and drainage of approximately 350ml coagulated, old blood. Thereafter, the entire circumference of the incisional wound was sutured. The postoperative course was good without re-adhesion of the hymen, and the onset of regular menstruation was observed after the surgery. Imperforate hymen is often observed in the neonatal period and adolescence. Adolescents tend to be hesitant to undergo inspection of the vulva; this may result in delayed diagnosis of such a condition. It is important to include the inspection of the vulva in the clinical examination of adolescents without menarche and complaining of lower abdominal pain without menarche. In addition, circular incision and suture of the incisional wound in the hymen is recommended in the treatment of this condition, in order to prevent hymen re-adhesion.
