Gynäkologie und Geburtshilfe
Offener Zugang

Abstrakt

Ein Pyokolpos, eine Pyometra, eine akute Nierenfunktionsstörung und eine schwere Sepsis, verursacht durch einen Klebsiella-Stamm bei einem 14-jährigen Mädchen mit Hymen imperforation, ein seltener Fallbericht und Literaturübersicht.

Yasmine El-Masry*, Ayman EL-Dorf, Ahmed ME Ossman

Background: Imperforate Hymen (IH) is considered the most common obstructive anomaly of the female reproductive tract. Infections, endometriosis, subfertility, or obstructive urinary symptoms could be complicated if went undetected. Treatment of uncomplicated IH is simple through hymenotomy (cruciate incision or excision of the hymen). Sepsis is not common to occur secondary to IH, but this case highlights it as a possible and evitable cause of sepsis in pediatrics and adolescents. Pyometra is rarely seen in children and clinical experience in managing this condition is limited. This review reported a rare case scenario with uncommon severe presentations seen in adolescent gynecology, it is a serious case, and fortunately, the pediatricians, emergency room physicians, and gynecologists are rarely facing such an issue. We provided our valuable experiences in the management of imperforate hymen that are complicated with pyocolpos and pyometra and extremely rare and severe sepsis caused by virulent Klebsiella strains in children which is extremely rare to infect them.

Conclusion: Besides the easiness of management of IH, it represents an evitable cause of more complications such as acute urine retention, sepsis, and subfertility. Suspicion should be raised for IH in adolescent girls presented with primary amenorrhea, acute abdomen, urinary manifestations, and emergencies.