EURORAD ESR

Case 10086

Acute urinary retention in an adolescent girl

Author(s)
Charsoula A1, Dimitriou C1, Kaziani T1, Patoulias I2, Papadimitriou A1, Kaitartzis C1

(1) Department of Radiology, G. Gennimatas General Hospital, Thessaloniki, Greece
(2) First Clinic of Pediatric Surgery, Gennimatas Hospital, Aristotle University of Thessaloniki Medical School, Thessaloniki, Greece
Email:cdimitriou@ymail.com
 
Patient
female, 13 year(s)
 
 
  • Figure 1
    US examination of the pelvis
     

    Large, tubular, cystic mass posterior to the urinary bladder, in the anatomic region of the vagina, with echogenic debris (suggesting blood clots) and without demonstrable blood flow.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Blood;

    Cystic, fluid-filled mass, posterior to the bladder, with layering echogenic material and without demonstrable blood flow.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Blood;

    After turning the patient from the prone to the supine position and with the urinary bladder being drained, US examination reveals mobility of the echogenic material, confirming its nature (suggesting blood clots).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Blood;

    After turning the patient from the prone to the supine position and with the urinary bladder being drained, US examination reveals mobility of the echogenic material, confirming its nature (blood clots)

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Blood;

    After turning the patient from the prone to the supine position and with the urinary bladder being drained, US examination reveals mobility of the echogenic material, confirming its nature (blood clots)

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Blood;
     
     
  • Figure 2
    US examination of the abdomen and pelvis
     

    A small amount of fluid is seen in the endometrial cavity. The connection of the uterus with the distended, fluid-filled vagina is demonstrated.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Mild dilatation of the pelvicalyceal system of the right kidney

     
    Area of Interest: Kidney; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Dilatation;

    Right ovary (normal findings).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Tissue characterisation;

    Left ovary (normal findings).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Tissue characterisation;
     
     
  • Figure 3
    Clinical examination of the perineum

    Inspection of the external genitalia reveals the pale blue imperforate hymen bulging from the introitus outwards

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Image manipulation / Reconstruction; Procedure: Education; Special Focus: Congenital;
     
     
  • Figure 4
    Surgical management

    Vertical hymenetomy under general anesthesia was performed and haematocolpos was drained.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Image manipulation / Reconstruction; Procedure: Drainage; Special Focus: Blood;
     
     
  • Figure 5
    Post-operative US examination
     

    Follow up pelvic US, 10 days after surgical treatment, reveals normal pelvic anatomy. Normal dimensions and appearance of uterus and vagina.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Tissue characterisation;

    Right and left ovary (normal findings).

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Tissue characterisation;

    Mild dilatation of the pelvicalyceal system of the right kidney persists after surgery.

     
    Area of Interest: Kidney; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Dilatation;
     
     
Large, tubular, cystic mass posterior to the urinary bladder, in the anatomic region of the vagina, with echogenic debris (suggesting blood clots) and without demonstrable blood flow.
 
Cystic, fluid-filled mass, posterior to the bladder, with layering echogenic material and without demonstrable blood flow.
 
After turning the patient from the prone to the supine position and with the urinary bladder being drained, US examination reveals mobility of the echogenic material, confirming its nature (suggesting blood clots).
 
After turning the patient from the prone to the supine position and with the urinary bladder being drained, US examination reveals mobility of the echogenic material, confirming its nature (blood clots)
 
After turning the patient from the prone to the supine position and with the urinary bladder being drained, US examination reveals mobility of the echogenic material, confirming its nature (blood clots)
 
A small amount of fluid is seen in the endometrial cavity. The connection of the uterus with the distended, fluid-filled vagina is demonstrated.
 
Mild dilatation of the pelvicalyceal system of the right kidney
 
Right ovary (normal findings).
 
Left ovary (normal findings).
 
Inspection of the external genitalia reveals the pale blue imperforate hymen bulging from the introitus outwards
 
Vertical hymenetomy under general anesthesia was performed and haematocolpos was drained.
 
Follow up pelvic US, 10 days after surgical treatment, reveals normal pelvic anatomy. Normal dimensions and appearance of uterus and vagina.
 
Right and left ovary (normal findings).
 
Mild dilatation of the pelvicalyceal system of the right kidney persists after surgery.
 
 
 
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