A 13-year-old female is brought to the emergency department with a complaint of severe, deep pelvic discomfort. Physical examination reveals that the patient has an intact hymen. Incision of the hymen reveals hematocolpos. Which of the following conditions is associated with hematocolpos?
Hematocolpos is characterized by filling of the vagina with menstrual blood. This commonly occurs due to the presence of an imperforate hymen. Bartholin gland ducts open into the vestibule of the vagina; therefore, a cyst in Bartholin gland would not cause hematocolpos. Blood from a ruptured ectopic pregnancy most often drains into the rectouterine pouch (of Douglas). Females often have a diminutive cremaster muscle and cremasteric artery and vein, but none of these is associated with hematocolpos. The cremasteric artery provides a small branch to the round ligament of the uterus (sometimes called "Samson's artery"), which must be kept in mind during a hysterectomy, with division of the round ligament. Bleeding from the uterine veins would not flow into the vagina.
Cyst of Bartholin gland
Bleeding from an ectopic pregnancy
Imperforate hymen
Indirect inguinal hernia with cremasteric arterial bleeding
Abdomen & Pelvis