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Last visited 12-04-2010 HYDROCOLPOS IN A NEONATE
Contributed by: Chinelo Okafor, Resident, Lutheran General Children's Hospital, Illinois, USA.
Patient: 1 day old female
History: Fullterm female neonate transferred from outside hospital with "a soft tissue mass bulging from the introitus." Antenatal sonogram, obtained 2 days prior to delivery, demonstrated a midline pelvic mass near the bladder. Abnormalities on physical exam: Abdomen with a ballotable mass. External Genitalia with normal female features and imperforate hymen.
Images:[small]larger

Fig. 1: Midline ultrasound image demonstrates distended vagina with echogenic debris. Bladder compressed anteriorly.
Findings: Postnatal Pelvic Ultrasound: FINDINGS: Midline complicated fluid collection posterior to the bladder.
Diagnosis: Hydrocolpos secondary to imperforate hymen
Discussion: Hydrocolpos is the distension of the vagina caused by accumulation of fluid due to congenital vaginal obstruction. The obstruction is often caused by an imperforate hymen or, less commonly, a transverse vaginal septum or vaginal atresia. The term "hydrometrocolpos" should be used when the expanded fluid-filled vaginal cavity is associated with distention of the uterine cavity itself. Hymenotomy was performed and 100 mL of serosanguinous fluid was drained. Follow-up ultrasound verified drainage of the obstructed vaginal opening. Patient discharged home. Hydrocolpos can be associated with genetic syndromes as well: 1) McKusick-Kaufman syndrome (MKS): genital abnormalities [Females:most commonly hydrocolpos / Males: hypospadias/chordee/cryptorchidism], Polydactyly, heart defects 2) Bardet-Biedl syndrome: presentation similar to MKS in neonatal period; with renal abnormalities/dysfunction, vision loss, developmental delay, obesity later on in life
References: (2008). Imaging of the Kidneys, Urinary Tract and Pelvis in Children. In Grainger & Allison's Diagnostic Radiology (5th ed.), [Online]. Available: MD Consult/Books/Adam: Grainger & Allison's Diagnostic Radiology/Chapter 66 - Imaging of the Kidneys, Urinary Tract and Pelvis in Children [2010, Dec 1]. Gaillard, F., MD. (2008 May 2). Hydrocolpos. Radiopaedia.org. Retrieved from http://radiopaedia.org/articles/hydrocolpos Genetics Home Reference: Your Guide to Understanding Genetic Conditions [Internet]. Bethesda (MD): The Library; McKusick-Kaufman Syndrome; 2008 May [published 2010 Nov 28; cited 2010 Dec 1]. Available from: http://ghr.nlm.nih.gov/condition/mckusick-kaufman-syndrome. Genetics Home Reference: Your Guide to Understanding Genetic Conditions [Internet]. Bethesda (MD): The Library; Bardet-Biedl Syndrome; 2010 May [published 2010 Nov 28; cited 2010 Dec 1]. Available from: http://ghr.nlm.nih.gov/condition/bardet-biedl-syndrome.
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Case Number: 48639517Last Updated: 12-04-2010
Anatomy: Genitourinary (GU)   Pathology: Congenital
Modality: USAccess Level: Readable by all users
Keywords: hydrocolpos

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