A rare case of pyometrocolpos: A consequence of distal vaginal septum

Pyometrocolpos resulting from congenital obstructing lesions can present during early childhood and adolescence with varying signs and symptoms. Children with pyometrocolpos due to distal vaginal obstruction may present as acutely ill with obstructive uropathy and septicaemia. We present a case of a two year old girl with pyometrocolpos in whom drainage under anaesthesia lead to marked improvement of her clinical symptoms. Hydrometrocolpos is a condition in which the uterus and vagina are distended by retained fl other than blood in the presence of distal vaginal outlet obstruction. Secondary infection of hydro- metrocolpos leads to pyometrocolpos (pyometra). The condition is rarely diagnosed in the neonate or infant until the obstruction causes a significant fluid collection in the vagina above the ob- structing septum and cause compression effect to the surrounding structures. Diagnosis is made initially by abdominal ultrasonogra- phy but magnetic resonance imaging (MRI) is used for defi nitive diagnosis. It can be diagnosed prenatally, during the third trimes- ter by transabdominal sonography (1). In children the hydrometro- colpos present usually as suprapubic cystic mass with or without retention of urine which may be an acute emergency (2). Urgent drainage of the infected cystic mass leads to marked improvement in the clinical course of such patients who require defi nitive sur- gery at a later stage (3). Rarity and variable presentations can lead to delayed diagnosis and erroneous management.