Hematocolpos secondary to imperforate hymen presenting with acute abdominal pain and misdiagnosed as appendicitis: a case report and literature review

Imperforate hymen is a rare congenital malformation that usually presents in adolescence with primary amenorrhoea and pain or pressure-related symptoms from haematocolpos. We present the case of an 11- year-old girl who presented as a surgical emergency with acute abdominal pain. A laparoscopy was performed for suspected appendicitis, but she was subsequently found to have a haematocolpos secondary to imperforate hymen. This case illustrates the challenges in making the diagnosis. The literature contains numerous cases where the diagnosis has been delayed, and we discuss those that also presented as possible appendicitis. These cases highlight the importance of awareness of the condition amongst general surgeons and emergency physicians, and the role of external genital examination and ultrasonography prior to surgical intervention.