Zusammenfassung
Hintergrund: Fehlentwicklungen des Müller-Gang-Systems kommen mit einer Inzidenz von 1:1000-1:5000
Geburten vor und sind häufig mit einer einseitigen Nierenagenesie assoziiert.
Kasuistik: Wir berichten über ein 12-jähriges Mädchen mit dysmenorrhoischen Beschwerden, die
sich mit jeder weiteren Regelblutung verstärkten. Die Ultraschalluntersuchung zeigte
einen Uterus duplex mit rechtsseitiger Vaginalatresie und Hämatometrokolpos sowie
eine ipsilaterale Nierenagenesie. Diagnostische Schwie-rigkeiten bereitete eine zystische
„Expansion” im kleinen Becken, die erst durch erweiterte Bildgebung (MRT und MR-Angiographie)
als Hämato-salpinx identifiziert werden konnte. Nach operativer Resektion des Vaginalseptums
bildeten sich der Hämatometrokolpos und die Hämatosalpinx spontan zurück.
Conclusion: Ein einseitiger Hämatometrokolpos sollte bei zyklischen Unterbauchschmerzen pubertierender
Mädchen auch bei regelmäßigen Monatsblutungen differenzialdiagnostisch in Betracht
gezogen werden.
Abstract
Background: Malformations of the mullerian-duct-system occur with an incidence of about 0.001-0.005%
of the population, and they are frequently associated with unilateral agenesis of
the kidney.
Case: A 12-year-old girl presented to our emergency department with cyclic abdominal pain
which increased with each of her menses. Ultrasound investigation showed a uterus
duplex with obstructed hemivagina and hematometrocolpos as well as an ipsilateral
absence of the kidney. Additionally, a cystic expansion in the small pelvis was detected
which required further investigations (MRT and MR-angiography) to establish the diagnosis
of a hematosalpinx. Excision of the vaginal septum resulted in drainage of the hemato-metrocolpos
and the hematosalpinx.
Conclusion: Unilateral hematometrocolpos should be considered as an important differential diagnosis
in female adolescents with relapsing lower abdominal pain, even if normal menstruation
occurs.
Schlüsselwörter
Uterus duplex - Hämatometrokolpos - Hämatosalpinx - Nierenagenesie
Key words
Uterus duplex - hematometrocolpos - hematosalpinx - renal agenesis
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Korrespondenzadresse
R. Kerbl
Abteilung für Allgemeine Pädiatrie
Universitätsklinik für Kinder- und Jugendheilkunde Graz
Auenbruggerplatz 30
A-8036 Graz
Österreich
Email: reinhold.kerbl@meduni-graz.at