Primary Amenorrhoea with Transverse Vaginal Septum Presented with Infected Pyometra of 24 Weeks Size

Abstract

Transverse vaginal septum is a congenital anomaly of the female genital outflow tract. It mostly remains unrecognized till adolescence and manifests as primary amenorrhoea with cyclic lower abdominal pain in background of appropriate Tanner staging secondary sex characterstics. Diagnosis is done by clinical examination and imaging, usually Magnetic Resonance Imaging. Early surgical management by vaginal or abdominal approaches improves the outcome. A 16 years, adolescent with appropriate Tanner staging secondary sex characteristics presented to gynecology (OPD) of Kathmandu Model Hospital with complaints of primary amenorrhoea and palpable abdominal mass of 24 weeks size with cyclic lower abdominal pain. Ultrasound showed features suggestive of hematometra. Under spinal anaesthesia, drainage and excision of the transverse vaginal septum was done followed by placement of vaginal mould post-operatively. We present here a case of primary amenorrhoea with pyometra secondary to transverse vaginal septum.