# Severe Abdominal Pain Mimicking Appendicitis Caused by Imperforate Hymen: Case Report and Narrative Review

**Authors:** Julia Kleina, Marcin Wieczorek, Karolina Markowska, Katarzyna Nierzwicka, Julia Leszkowicz, Agnieszka Szlagatys-Sidorkiewicz

PMC · DOI: 10.3390/pediatric18010010 · Pediatric Reports · 2026-01-13

## TL;DR

A 14-year-old girl with severe abdominal pain was found to have an imperforate hymen, a rare condition that can mimic appendicitis and requires simple surgical treatment.

## Contribution

This case highlights the importance of considering imperforate hymen in the differential diagnosis of abdominal pain in adolescent girls.

## Key findings

- The patient's symptoms were caused by an imperforate hymen leading to menstrual blood retention.
- Hymenotomy resolved the condition without complications.
- Early diagnosis is crucial to prevent complications in similar cases.

## Abstract

An imperforate hymen is a rare congenital genital anomaly causing menstrual blood retention during puberty. Treatment consists of a simple surgical incision of the hymenal membrane. We present a case of a 14-year-old girl who was admitted to the Emergency Department with severe lower abdominal pain mimicking appendicitis. Medical history revealed a lack of menses and several months of cyclic abdominal pain. Imaging diagnostics confirmed an imperforate hymen with hematometrocolpos. Hymenotomy was performed with full recovery without complications. An imperforate hymen should be considered in the differential diagnosis of abdominal pain in adolescent girls, especially without expected menstruation. Early recognition allows for prompt treatment and prevents complications.

## Linked entities

- **Diseases:** appendicitis (MONDO:0005649)

## Full-text entities

- **Diseases:** congenital genital anomaly (MESH:D000013), Abdominal Pain (MESH:D015746), Imperforate Hymen (MESH:C562397), menstrual blood retention (MESH:D004412), Appendicitis (MESH:D001064)

## Full text

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## Figures

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## References

31 references — full list in the complete paper: https://tomesphere.com/paper/PMC12821681/full.md

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Source: https://tomesphere.com/paper/PMC12821681