A 14-year-old premenarcheal adolescent girl presented with lower
abdominal discomfort and urine retention. After clinical and imaging
examination, an imperforate hymen and a large hematocolpos along the
upper part of the vagina was diagnosed. Incision of the imperforate
hymen did not lead to drainage of blood or fluid. A complete transverse
vaginal septum in the middle third of the vagina was identified and when
incised drained approximately 200 mL of a dense brownish fluid.
Laparoscopy showed a small unicornuate uterus, confirmed by
hysteroscopy. This is the first case in the literature of concurrent
imperforate hymen, transverse complete vaginal septum, and unicornuate
uterus, and it highlights the potential of a multifactorial embryologic
genetic etiology. (C) 2007 Elsevier Inc. All rights reserved
