TY - CHAP M1 - Book, Section TI - Imperforate Hymen A1 - Dooley-Hash, Suzanne A1 - Knoop, Kevin J. A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason PY - 2021 T2 - The Atlas of Emergency Medicine, 5e AB - The hymen is normally a perforate membrane seen at the vaginal introitus where it separates the vestibule externally from the vagina internally. Imperforate hymen refers to the congenital absence of a hymenal orifice. This condition may present in infants or young children as a smooth, glistening membrane protruding from the introitus due to the buildup of vaginal secretions known as a mucocolpos. More commonly, it presents in adolescent girls with the accumulation of menstrual blood and secretions behind the hymen, known as a hematocolpos. The fluid collection can become large enough to compress the bladder neck and cause urinary retention. Occasionally, the accumulated blood spilling into the peritoneal cavity through the fallopian tubes results in free pelvic fluid and signs of peritonitis. On examination, hematocolpos is evident as a smooth, dome-shaped, bluish-red bulging membrane at the introitus. A large, smooth, cystic mass can often be palpated anteriorly on digital rectal examination. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1181041687 ER -